Provider Demographics
NPI:1871478883
Name:KELLER, COLTON CLIFF (PHARMD)
Entity type:Individual
Prefix:
First Name:COLTON
Middle Name:CLIFF
Last Name:KELLER
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 1:168 S 550 W
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-5219
Mailing Address - Country:US
Mailing Address - Phone:208-406-8838
Mailing Address - Fax:
Practice Address - Street 1:1017 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-3049
Practice Address - Country:US
Practice Address - Phone:435-723-5211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14227292-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist