Provider Demographics
NPI:1467497628
Name:GRIFFIN, DIANA O (PT)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:O
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 W WEAVER ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-2084
Mailing Address - Country:US
Mailing Address - Phone:919-942-0240
Mailing Address - Fax:919-942-0280
Practice Address - Street 1:304 W WEAVER ST
Practice Address - Street 2:SUITE 103
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-2084
Practice Address - Country:US
Practice Address - Phone:919-942-0240
Practice Address - Fax:919-942-0280
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4461225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist