Healthcare Provider Details

I. General information

NPI: 1659940641
Provider Name (Legal Business Name): COLTON TROWBRIDGE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 06/23/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 S SYCAMORE AVE
SIOUX FALLS SD
57110-4207
US

IV. Provider business mailing address

1720 S SYCAMORE AVE
SIOUX FALLS SD
57110-4207
US

V. Phone/Fax

Practice location:
  • Phone: 605-221-0782
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6848
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: