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General NPI Number Information
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NPI Number | 1962993139
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Entity Type | Individual
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Provider Name | ETHAN EARL GRIFFEL DPT
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Gender | Male
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Dates
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Enumeration Date | 05/23/2018
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 103 N N ST
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City | LIVINGSTON
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State | MT
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Zip | 59047-2826
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Country | US
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Telephone | 208-317-0287
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Fax | 208-317-0287
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Provider Business Mailing Address
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Address Line | 1001 S MAIN ST STE 600
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City | KALISPELL
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State | MT
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Zip | 59901-1498
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Country | US
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Telephone | 406-219-8017
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 14949
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License Number State | MT
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