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Individual

DR. GARY A GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
670 SHEPARD LN, SUITE 102, FARMINGTON, UT 84025-3936
(801) 451-7500
(801) 451-6966
Mailing address
670 SHEPARD LN, SUITE 102, FARMINGTON, UT 84025-3936
(801) 451-7500
(801) 451-6966

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
104878-0501
UT

Other

Enumeration date
08/01/2005
Last updated
09/20/2007
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