Provider Demographics
NPI:1124594122
Name:JUST, GRIFFIN
Entity Type:Individual
Prefix:
First Name:GRIFFIN
Middle Name:
Last Name:JUST
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2244 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-2214
Mailing Address - Country:US
Mailing Address - Phone:205-418-1082
Mailing Address - Fax:205-418-1082
Practice Address - Street 1:2244 NORTH RD
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2214
Practice Address - Country:US
Practice Address - Phone:205-418-1082
Practice Address - Fax:205-418-1082
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH9023225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist