Healthcare Provider Details

I. General information

NPI: 1467599266
Provider Name (Legal Business Name): SCOTT J GRIFFIN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 10/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6625 S RURAL RD STE 104
TEMPE AZ
85283-3717
US

IV. Provider business mailing address

6625 S RURAL RD STE 104
TEMPE AZ
85283-3717
US

V. Phone/Fax

Practice location:
  • Phone: 480-833-4515
  • Fax: 480-833-5078
Mailing address:
  • Phone: 480-833-4515
  • Fax: 480-833-5078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7478
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number462
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: