Individual
SUSAN R DYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
619 N 500 W, PROVO, UT 84601-1547
(801) 852-9440
(801) 852-9449
Mailing address
619 N 500 W, PROVO, UT 84601-1547
(801) 852-9440
(801) 852-9449
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1754051206
UT
Other
Enumeration date
07/20/2006
Last updated
11/16/2016
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