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Individual

DR. BRANDON C. GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3000 N TRIUMPH BLVD STE 110, LEHI, UT 84043-4999
(385) 345-3555
Mailing address
3000 N TRIUMPH BLVD STE 110, LEHI, UT 84043-4999
(801) 505-5370

Taxonomy

Speciality
Code
Description
License number
State
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
9374436-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3004771
UT
Enumeration date
02/25/2009
Last updated
07/13/2023
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