Organization
STACY GREEN ENTERPRISES, LLC
Active
Other names
Dr. Stacy Green, M.D., LLC
Organization subpart
No
Provider details
NPI number
Authorized official
STACY ROBIN GREEN MD (OWNER)
(303) 717-2521
Entity
Organization
Contact information
Practice address
825 S BROADWAY ST STE 100, BOULDER, CO 80305-5932
(303) 717-2521
Mailing address
825 S BROADWAY ST STE 100, BOULDER, CO 80305-5932
(303) 717-2521
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
09/09/2021
Last updated
10/22/2025
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