Individual
MICHAEL CAYMAN GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
5205 E CORTLAND BLVD APT 174, FLAGSTAFF, AZ 86004-9314
(575) 640-1041
Mailing address
5205 E CORTLAND BLVD APT 174, FLAGSTAFF, AZ 86004-9314
(575) 640-1041
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000035823
ATHLETIC TRAINER - BOARD OF CERTIFICATION
—
Enumeration date
01/18/2019
Last updated
12/06/2020
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