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General NPI Number Information
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NPI Number | 1992251169
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Entity Type | Individual
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Provider Name | ABIGAEL GRIFFIN LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 11/11/2018
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Provider Practice Location Address
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Address Line | 111 LAKE HOLLINGSWORTH DR
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City | LAKELAND
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State | FL
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Zip | 33801-5607
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Country | US
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Telephone | 407-637-0960
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Fax |
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Provider Business Mailing Address
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Address Line | 287 SHADY OAKS CIR
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City | LAKE MARY
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State | FL
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Zip | 32746-3698
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Country | US
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Telephone |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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