Healthcare Provider Details

I. General information

NPI: 1104857275
Provider Name (Legal Business Name): SCOTT E. GRIFFIN, D.C., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 SUMMER DR
CAREY OH
43316-3503
US

IV. Provider business mailing address

923 SUMMER DR
CAREY OH
43316-3503
US

V. Phone/Fax

Practice location:
  • Phone: 419-396-6343
  • Fax: 419-396-3098
Mailing address:
  • Phone: 419-396-6343
  • Fax: 419-396-3098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1563
License Number StateOH

VIII. Authorized Official

Name: SCOTT E GRIFFIN
Title or Position: OWNER
Credential: D.C.
Phone: 419-396-6343