Organization
PATRICK GREEN MD PLLC
Active
Other names
Bonneville Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK NELSON GREEN MD (OWNER)
(801) 792-7335
Entity
Organization
Contact information
Practice address
134 W 1180 N SUITE # 5, TOOELE, UT 84074
(435) 248-0333
(435) 248-0334
Mailing address
134 W 1180 N STE 5, TOOELE, UT 84074-1483
(435) 248-0333
(435) 248-0334
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/29/2011
Last updated
12/27/2024
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