Green, Justin D
Green, Justin D is an sole proprietor health care provider with primary practice located at 5277 Manhattan Cir Suite 100, Boulder CO 80303-8201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Green, Justin D can be contacted via phone (720) 304-8154.Contact Information
Primary practice address
5277 Manhattan Cir Suite 100
Boulder CO 80303-8201
Phone: (720) 304-8154
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 32177 | Colorado |
Profile Details
| NPI number | 1841355971 |
|---|---|
| LBN Legal business name | Green, Justin D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 27th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841355971 | NPPES |
| Colorado | MEDICAID | 01321777 |
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