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NPI Code Detail

MEDICARE: DR. SHANNON A GRIFFIN D.C.

MEDICARE: DR. SHANNON A GRIFFIN D.C.
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
1111N00000XChiropractorCH7473FL

General Provider Information

NPI Number : 1134218365
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANNON A GRIFFIN D.C.
Provider Business Mailing Address
First Line : 600 N US HIGHWAY 1
Second Line :
City : FORT PIERCE
State : FL
Zip : 34950-3072
Country : US
Telephone Number : 772-978-9916
Fax Number : 772-978-9918
Provider Business Practice Location Address
First Line : 600 N US HIGHWAY 1
Second Line :
City : FORT PIERCE
State : FL
Zip : 34950-3072
Country : US
Telephone Number : 772-978-9916
Fax Number : 772-978-9918
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 11/17/2009

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