MEDICARE: COLBY LEWIS GRIFFIN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PTL.0020507	CO
2	225100000X	Physical Therapist	046080	NY
3	225100000X	Physical Therapist	PT017567	GA
4	225100000X	Physical Therapist	LPT-034421	AZ

General Provider Information

NPI Number	:	1073114963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLBY LEWIS GRIFFIN DPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-497-0005
Fax Number	:

Provider Business Practice Location Address
First Line	:	1715 HOWELL MILL RD NW STE B
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-3113
Country	:	US
Telephone Number	:	404-351-5432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2020
Last Update Date	:	12/17/2025

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