Healthcare Provider Details

I. General information

NPI: 1396784492
Provider Name (Legal Business Name): DARWIN I GRIFFETH IV D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 N HIGHWAY 161 SUITE 300
IRVING TX
75039-2804
US

IV. Provider business mailing address

546 E SANDY LAKE RD SUITE 110
COPPELL TX
75019-5786
US

V. Phone/Fax

Practice location:
  • Phone: 972-755-8119
  • Fax: 214-615-9734
Mailing address:
  • Phone: 972-393-8067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number10065
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: