Individual
JUSTIN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3917 WEST RD STE A, LOS ALAMOS, NM 87544-2292
(505) 661-8900
Mailing address
3917 WEST RD, LOS ALAMOS, NM 87544-2275
(505) 661-8900
(505) 661-8916
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4568
SD
Other
Enumeration date
06/05/2006
Last updated
09/27/2024
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