Provider Demographics
NPI:1265665392
Name:DR KREG GRIFFITH P.C.
Entity Type:Organization
Organization Name:DR KREG GRIFFITH P.C.
Other - Org Name:GRIFFITH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KREG
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-408-2669
Mailing Address - Street 1:547 E MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:OK
Mailing Address - Zip Code:73093-4716
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:414 SE 11TH ST
Practice Address - Street 2:
Practice Address - City:ANADARKO
Practice Address - State:OK
Practice Address - Zip Code:73005-4442
Practice Address - Country:US
Practice Address - Phone:405-408-2669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty