Individual
JASON CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1435 VILLAGE DR, DEPARTMENT 2801, OGDEN, UT 84408-5150
(801) 626-7771
Mailing address
1824 SHOSHONE DR, OGDEN, UT 84403-4685
(208) 224-0479
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
UT
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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