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Organization

GREEN SPORTS MEDICINE INC

Active
Other names
Green Sports Medicine, Inc.
Organization subpart
No

Provider details

NPI number
Authorized official
ERICK GREEN MD (MD)
(559) 813-3005
Entity
Organization

Contact information

Practice address
2021 HERNDON AVE STE 201, CLOVIS, CA 93611-6101
(559) 981-5566
(559) 228-9989
Mailing address
7471 N FRESNO ST, FRESNO, CA 93720-2457
(559) 981-5566
(559) 228-9989

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician

Other

Enumeration date
10/03/2018
Last updated
11/18/2019
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