Individual
ROGER LYNN COLVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
990 MEDICAL DR STE U4, BRIGHAM CITY, UT 84302-4714
(435) 723-6487
(435) 723-6490
Mailing address
990 MEDICAL DR STE U4, BRIGHAM CITY, UT 84302-4714
(435) 723-6487
(435) 723-6490
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
114380-2401
UT
2251X0800X
Orthopedic Physical Therapist
114380-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870375865000
—
UT
Enumeration date
08/30/2006
Last updated
03/10/2008
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