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General NPI Number Information
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NPI Number | 1518453869
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Entity Type | Organization
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Legal Business Name | GRIFFITH SAYLES OD, OPTOMETRY CORPORATION
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Dates
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Enumeration Date | 07/10/2018
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Last Update Date | 01/31/2019
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Provider Practice Location Address
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Address Line | 1275 AIRPORT PARK BLVD.
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City | UKIAH
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State | CA
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Zip | 95482
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Country | US
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Telephone | 206-370-1016
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Fax |
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Provider Business Mailing Address
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Address Line | 1275 AIRPORT PARK BLVD
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City | UKIAH
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State | CA
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Zip | 95482-7400
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Country | US
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Telephone | 707-313-8019
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. GRIFFITH SAYLES
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Credential | OD
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Telephone | 707-313-8019
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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 | 33605
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License Number State | CA
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