Individual
JASON THUC WU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1326
Mailing address
23182 VISTA WAY, LAKE FOREST, CA 92630-3820
(949) 394-4764
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
13875173-9934
UT
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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