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Individual

SUPRIYA JAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4700 LADY MOON DR, FORT COLLINS, CO 80528-4426
(970) 810-3894
Mailing address
2000 BOISE AVE, LOVELAND, CO 80538-5006

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
036-150328
IL

Other

Enumeration date
03/29/2014
Last updated
07/08/2022
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