Individual
NATHAN RAY GREEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1818 S 300 W, SALT LAKE CITY, UT 84115-1805
(801) 485-9757
Mailing address
1818 S 300 W, SALT LAKE CITY, UT 84115-1805
(801) 485-9757
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5340358-9934
UT
Other
Enumeration date
01/03/2006
Last updated
07/08/2007
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