Individual
WILLIAM D GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
380 E 1500 S, HEBER CITY, UT 84032-3940
(435) 654-5607
(435) 654-2602
Mailing address
380 E 1500 S, HEBER CITY, UT 84032-3940
(435) 654-5607
(435) 654-2602
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1178502401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88815
PEHP
UT
05
—
D6533
—
UT
Enumeration date
07/31/2006
Last updated
07/09/2007
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