Healthcare Provider Details

I. General information

NPI: 1114288172
Provider Name (Legal Business Name): ALLEN D GRIFFITHS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 E COURT ST
WASHINGTON COURT HOUSE OH
43160-1357
US

IV. Provider business mailing address

239 E COURT ST
WASHINGTON COURT HOUSE OH
43160-1357
US

V. Phone/Fax

Practice location:
  • Phone: 740-335-2771
  • Fax: 740-335-2771
Mailing address:
  • Phone: 740-335-2771
  • Fax: 743-335-2771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ALLEN DALE GRIFFITHS
Title or Position: OWNER
Credential: OD
Phone: 740-335-3578