Healthcare Provider Details

I. General information

NPI: 1265346332
Provider Name (Legal Business Name): JAYQUAN JALEN GRIFFITH DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 UNIVERSITY OFFICE BLVD BLDG 14A
PENSACOLA FL
32504-6475
US

IV. Provider business mailing address

600 UNIVERSITY OFFICE BLVD BLDG 14A
PENSACOLA FL
32504-6475
US

V. Phone/Fax

Practice location:
  • Phone: 850-565-9600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH15034
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: