MEDICARE: CHRISTOPHER GRIFFITH

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	225700000X	Massage Therapist	1671	MS
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1679891873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER GRIFFITH

Provider Business Mailing Address
First Line	:	8326 KELWOOD AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-4803
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 VILLAGE ST
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70458-5302
Country	:	US
Telephone Number	:	601-347-0959
Fax Number	:

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

Provider Enumeration Date	:	05/12/2010
Last Update Date	:	06/28/2021

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