Individual
NATHANIEL GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1025 S MILTON RD, FLAGSTAFF, AZ 86001-6349
(928) 779-9588
Mailing address
78 N GRANADA CIR, CASA GRANDE, AZ 85122-5706
(520) 229-7196
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S019128
AZ
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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