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General NPI Number Information
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NPI Number | 1023708153
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Entity Type | Individual
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Provider Name | AMANDA MICHELLE GRIFFIN OD
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Gender | Female
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 120 SIMONS RUN STE H
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City | LYNCHBURG
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State | VA
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Zip | 24502-8902
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Country | US
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Telephone | 434-382-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 429 BLACKFORD ST UNIT 1
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City | LYNCHBURG
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State | VA
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Zip | 24504-2246
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Country | US
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Telephone | 269-209-5453
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901005699APP23
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618003339
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License Number State | VA
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