Provider Demographics
NPI:1528665809
Name:FRAZIER, COLTON ANTHONY (DPT)
Entity type:Individual
Prefix:
First Name:COLTON
Middle Name:ANTHONY
Last Name:FRAZIER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 W NYE LN STE 102
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-1571
Mailing Address - Country:US
Mailing Address - Phone:971-772-0940
Mailing Address - Fax:503-902-0582
Practice Address - Street 1:5 PINE CONE RD STE 100
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:NV
Practice Address - Zip Code:89403-6309
Practice Address - Country:US
Practice Address - Phone:971-772-0940
Practice Address - Fax:503-902-0582
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4304225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist