Organization
NATHAN GREEN O.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN RAY GREEN OD (PRESIDENT)
(801) 485-9757
Entity
Organization
Contact information
Practice address
1818 S 300 W, SALT LAKE CITY, UT 84115-1805
(801) 485-9757
(801) 485-8867
Mailing address
1818 S 300 W, SALT LAKE CITY, UT 84115-1805
(801) 485-9757
(801) 485-8867
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5340358-9934
UT
Other
Enumeration date
11/28/2007
Last updated
11/28/2007
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