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General NPI Number Information
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NPI Number | 1821023649
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Entity Type | Individual
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Provider Name | ELAINE D. GRIFFIN P.T.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 8033 OUSLEY RD
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City | VALDOSTA
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State | GA
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Zip | 31601-1011
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Country | US
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Telephone | 229-253-8415
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Fax | 229-249-9976
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Provider Business Mailing Address
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Address Line | 707 THORNBROOKE CT
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City | VALDOSTA
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State | GA
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Zip | 31602-1391
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Country | US
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Telephone | 229-630-0254
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Fax | 229-630-0254
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT001107
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License Number State | GA
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