Individual
DR. MATTHEW COLLIN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., J.D.
Contact information
Practice address
1157 N 300 W, SUTIE 201, PROVO, UT 84604-6124
(801) 357-1200
Mailing address
PO BOX 27128, SUITE 201, SALT LAKE CITY, UT 84127-0128
(801) 357-1200
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
8351448-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/10/2011
Last updated
12/27/2012
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