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NPI 1477738391

NPI 1477738391 : TIMOTHY PATRICK GRIFFIN PT : PORTLAND, ME

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General NPI Number Information
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    NPI Number           |    1477738391
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    Entity Type          |    Individual 
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    Provider Name        |    TIMOTHY PATRICK GRIFFIN PT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/09/2008
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    Last Update Date     |    06/25/2015
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Provider Practice Location Address
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    Address Line         |    50 SEWALL ST SUITE 101
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    City                 |    PORTLAND
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    State                |    ME
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    Zip                  |    04102-2645
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    Country              |    US
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    Telephone            |    207-772-7662
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    73 NEWTON RD SUITE 101
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    City                 |    PLAISTOW
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    State                |    NH
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    Zip                  |    03865-2424
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    Country              |    US
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    Telephone            |    978-388-7272
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    Fax                  |    978-388-7373
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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        |    2251E1200X
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    Taxonomy Name        |    Ergonomics Physical Therapist
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    License Number       |    1430
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    License Number State |    ME
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Taxonomy #2
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    Taxonomy Code        |    2251S0007X
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    Taxonomy Name        |    Sports Physical Therapist
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    License Number       |    1430
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    License Number State |    ME
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Taxonomy #3
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    Taxonomy Code        |    2251X0800X
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    Taxonomy Name        |    Orthopedic Physical Therapist
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    License Number       |    1430
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    License Number State |    ME
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