Healthcare Provider Details
I. General information
NPI: 1114302288
Provider Name (Legal Business Name): KADRIA GRIFFITHS-SCOTT DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/29/2015
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1323 ROSWELL RD STE 300
MARIETTA GA
30062-3667
US
IV. Provider business mailing address
1415 BARCLAY CIR SE
MARIETTA GA
30060-2943
US
V. Phone/Fax
- Phone: 770-426-2786
- Fax: 770-792-6113
- Phone: 770-426-2786
- Fax: 770-792-6113
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | CHIR009558 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: