Healthcare Provider Details

I. General information

NPI: 1487711628
Provider Name (Legal Business Name): VALERIE G GRIFFITH PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 07/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 LOCH RAVEN BLVD 4 WEST
BALTIMORE MD
21239-2945
US

IV. Provider business mailing address

2737 N CALVERT ST
BALTIMORE MD
21218-4405
US

V. Phone/Fax

Practice location:
  • Phone: 443-444-4034
  • Fax:
Mailing address:
  • Phone: 410-664-8945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number19631
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: