Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC19136 | CA |
NPI | 1174558340 |
---|---|
Provider Name | John A Griffin |
First Address | Lancaster, CA 93534-3684 |
Second Address | Lancaster, CA 93534-3684 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 22/04/2008 |