Individual
COLTON TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(989) 482-1512
Mailing address
625 BARLOW ST, TRAVERSE CITY, MI 49686-3304
(989) 482-1512
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601012314
MI
Other
Enumeration date
02/16/2024
Last updated
02/16/2024
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