Individual
PACE ANTHONY COLLESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
344 EAST 100 SOUTH, STE 301, SALT LAKE CITY, UT 84111
(801) 322-4257
Mailing address
7210 EAST 700 NORTH, HUNTSVILLE, UT 84317
(203) 807-3510
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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