Provider Demographics
NPI:1811775984
Name:CRITCHLOW, COLTON JOSEPH (PHARMD)
Entity type:Individual
Prefix:
First Name:COLTON
Middle Name:JOSEPH
Last Name:CRITCHLOW
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1832 W 680 N
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-4078
Mailing Address - Country:US
Mailing Address - Phone:801-682-0407
Mailing Address - Fax:
Practice Address - Street 1:1707 W STATE RD
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-5045
Practice Address - Country:US
Practice Address - Phone:801-216-0003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT102775351701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist