Individual
DOUGLAS ALLAN GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
214 W 1500 S, BOUNTIFUL, UT 84010-7408
(801) 295-6483
Mailing address
PO BOX 307, BOUNTIFUL, UT 84011-0307
(801) 294-6907
(801) 294-6917
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
353133-1206
UT
Other
Enumeration date
11/28/2006
Last updated
01/21/2010
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