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Individual

JASON T SU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1055 N 300 W STE 311, PROVO, UT 84604-3373
(385) 477-6800
(385) 477-6801
Mailing address
1055 N 300 W STE 311, PROVO, UT 84604-3373
(385) 477-6800
(385) 477-6801

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
5665627-1204
UT
2080P0202X
Pediatric Cardiology Physician
DO3974
ME

Other

Enumeration date
11/03/2006
Last updated
10/18/2024
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