Individual
MR. ERIC ROSS GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CP
Contact information
Practice address
FAIRFAX ROAD AT VIRGINIA ST., SALT LAKE CITY, UT 84103-4399
(801) 536-3820
Mailing address
FAIRFAX ROAD AT VIRGINIA ST., SALT LAKE CITY, UT 84103-4399
(801) 536-3820
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/08/2010
Last updated
03/08/2010
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