NPI 1295372522 · live from the CMS NPI Registry
Jeremy D Green
Audiologist in Logan, UT. National Provider Identifier 1295372522, active.
NPI record
| NPI | 1295372522 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Audiologist 231H00000X |
| Practice location | 293 S Main St, Logan, UT 84321 |
| Practice phone | 435-753-4133 |
| Enumerated | December 5, 2019 |
| Last updated | December 5, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Audiologist primary | 231H00000X | 10966451-4101 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.