Healthcare Provider Details

I. General information

NPI: 1083542047
Provider Name (Legal Business Name): ROBERT GAVIN GRIFFIN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3102 RAINBOW DR STE 200
RAINBOW CITY AL
35906-5804
US

IV. Provider business mailing address

3102 RAINBOW DR STE 200
RAINBOW CITY AL
35906-5804
US

V. Phone/Fax

Practice location:
  • Phone: 256-543-0717
  • Fax: 256-543-0718
Mailing address:
  • Phone: 256-543-0717
  • Fax: 256-543-0718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH12678
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: