Healthcare Provider Details

I. General information

NPI: 1245393347
Provider Name (Legal Business Name): DEUCE CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

366 SOUTH WASHINGTON ST
TIFFIN OH
44883-3007
US

IV. Provider business mailing address

366 SOUTH WASHINGTON ST
TIFFIN OH
44883-3007
US

V. Phone/Fax

Practice location:
  • Phone: 419-447-1861
  • Fax:
Mailing address:
  • Phone: 419-447-1861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: ERIC GRIFFIN
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: DC
Phone: 419-447-1861