Individual
COLBY B PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1380 E MEDICAL CENTER DR, STE # 4100, ST GEORGE, UT 84790-2156
(435) 251-2900
(435) 251-2901
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
370382-1206
UT
Other
Enumeration date
06/05/2006
Last updated
11/27/2023
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