Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1023286564 |
---|---|
Provider Name | Paula Griffin |
First Address | Grove City, PA 16127-4447 |
Second Address | Grove City, PA 16127-4447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2008 |
Last Update Date | 19/02/2008 |