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General NPI Number Information
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NPI Number | 1841174588
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Entity Type | Individual
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Provider Name | GRIFFIN KEITH LEWALLEN PT
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Gender | Male
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 13596 HIGHWAY 231 431 N STE 7
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City | HAZEL GREEN
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State | AL
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Zip | 35750-8618
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Country | US
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Telephone | 256-539-2728
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Fax |
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Provider Business Mailing Address
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Address Line | 927 FRANKLIN ST SE
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4306
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Country | US
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Telephone | 256-539-2728
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Fax | 256-704-0915
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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 | PTH12322
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License Number State | AL
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