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General NPI Number Information
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NPI Number | 1528665809
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Entity Type | Individual
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Provider Name | COLTON ANTHONY FRAZIER DPT
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Gender | Male
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Dates
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Enumeration Date | 10/08/2020
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 5 PINE CONE RD STE 100
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City | DAYTON
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State | NV
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Zip | 89403-6309
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Country | US
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Telephone | 971-772-0940
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Fax | 503-902-0582
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Provider Business Mailing Address
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Address Line | 844 W NYE LN STE 102
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City | CARSON CITY
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State | NV
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Zip | 89703-1571
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Country | US
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Telephone | 971-772-0940
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Fax | 503-902-0582
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4304
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License Number State | NV
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