Healthcare Provider Details

I. General information

NPI: 1750330494
Provider Name (Legal Business Name): NICHOLAS SPENCER GRIFFITHS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7343 PARK AVE
ALLEN PARK MI
48101-1902
US

IV. Provider business mailing address

7343 PARK AVE
ALLEN PARK MI
48101-1902
US

V. Phone/Fax

Practice location:
  • Phone: 313-582-1040
  • Fax: 313-582-3642
Mailing address:
  • Phone: 313-582-1040
  • Fax: 313-582-3642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number2301008167
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301008167
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: