Provider Demographics
NPI:1952806168
Name:KING, COLTON (DC)
Entity Type:Individual
Prefix:
First Name:COLTON
Middle Name:
Last Name:KING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7161 N HOWARD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2981
Mailing Address - Country:US
Mailing Address - Phone:559-227-2273
Mailing Address - Fax:559-227-3473
Practice Address - Street 1:7161 N HOWARD ST STE 100
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2981
Practice Address - Country:US
Practice Address - Phone:559-227-2273
Practice Address - Fax:559-227-3473
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC34132111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor