Healthcare Provider Details

I. General information

NPI: 1811184229
Provider Name (Legal Business Name): BRIAN J GREER CP, BOCO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2007
Last Update Date: 10/16/2020
Certification Date: 10/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 E WINCHESTER ST STE 275
MURRAY UT
84107-7757
US

IV. Provider business mailing address

480 E WINCHESTER ST STE 275
MURRAY UT
84107-7757
US

V. Phone/Fax

Practice location:
  • Phone: 801-997-1367
  • Fax: 801-997-1367
Mailing address:
  • Phone: 801-997-1367
  • Fax: 801-997-1367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: