Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1642 | MS |
NPI | 1487697702 |
---|---|
Provider Name | Mrs. Dorcus Layatta Griffin |
First Address | Hattiesburg, MS 39401-4934 |
Second Address | Hattiesburg, MS 39401-4934 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 08/07/2007 |