Individual
JENETT GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5121 COTTONWOOD ST, BOX 577000, MURRAY, UT 84107-5701
(801) 507-7000
Mailing address
238 E 900 N, NEPHI, UT 84648-1029
(435) 623-0604
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
106283-8019
UT
Other
Enumeration date
01/27/2011
Last updated
01/27/2011
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