Healthcare Provider Details

I. General information

NPI: 1174460356
Provider Name (Legal Business Name): CASEY BRIAN GREENE PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 E SOUTH TEMPLE STE 150
SALT LAKE CITY UT
84111-1279
US

IV. Provider business mailing address

370 E SOUTH TEMPLE STE 150
SALT LAKE CITY UT
84111-1279
US

V. Phone/Fax

Practice location:
  • Phone: 801-521-9222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: