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General NPI Number Information
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NPI Number | 1952988438
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Entity Type | Individual
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Provider Name | EZEKIEL J GRIFFIN OT/L
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Gender | Male
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 8648 OLD SAVANNAH LN
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City | MONTGOMERY
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State | AL
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Zip | 36116-6610
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Country | US
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Telephone | 205-249-1857
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Fax |
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Provider Business Mailing Address
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Address Line | 8648 OLD SAVANNAH LN
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City | MONTGOMERY
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State | AL
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Zip | 36116-6610
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Country | US
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Telephone | 205-249-1857
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Fax |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 3538
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License Number State | AL
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