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General NPI Number Information
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NPI Number | 1699207571
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Entity Type | Individual
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Provider Name | COLTER J BOITA D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/30/2017
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 218 MUSHROOM DR
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City | BAYFIELD
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State | CO
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Zip | 81122-9718
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Country | US
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Telephone | 970-903-1136
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Fax |
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Provider Business Mailing Address
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Address Line | 2012 N 21ST ST
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-6712
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Country | US
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Telephone | 970-903-1136
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DR.0070367
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 301226
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License Number State | NY
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