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General NPI Number Information
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NPI Number | 1407613763
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Entity Type | Organization
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Legal Business Name | TIFFANY ADULT WELLNESS AND WEIGHT LOSS LLC
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 900 TRAIL RIDGE RD STE 124
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City | AIKEN
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State | SC
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Zip | 29803-7765
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Country | US
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Telephone | 839-777-8052
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 247
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City | BATH
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State | SC
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Zip | 29816-0247
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Country | US
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Telephone | 839-777-8052
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY GRIFFIN
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Credential | NP
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Telephone | 646-272-8417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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