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General NPI Number Information
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NPI Number | 1508135401
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Entity Type | Organization
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Legal Business Name | GRIFFIN CHIROPRACTIC CLINIC, INC.
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 12/21/2011
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Provider Practice Location Address
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Address Line | 700 S ENOTA DR NE SUITE 201
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City | GAINESVILLE
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State | GA
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Zip | 30501-2403
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Country | US
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Telephone | 770-532-4084
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Fax |
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Provider Business Mailing Address
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Address Line | 700 S ENOTA DR NE SUITE 201
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City | GAINESVILLE
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State | GA
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Zip | 30501-2403
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Country | US
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Telephone | 770-532-4084
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Fax |
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | DR. CLIFFORD STANLEY GRIFFIN SR.
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Credential | D.C.
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Telephone | 770-532-4084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2451
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License Number State | GA
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