Provider Demographics
NPI:1508638776
Name:GRIFFITH, GILLIAN
Entity Type:Individual
Prefix:
First Name:GILLIAN
Middle Name:
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LSU ATHLETIC TRAINING ATHLETICS ADMINISTRATION BUILDING
Mailing Address - Street 2:ATTN: ATHLETIC TRAINING ROOM
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70803
Mailing Address - Country:US
Mailing Address - Phone:843-412-2785
Mailing Address - Fax:
Practice Address - Street 1:1 NORTH SATDIUM DRIVE
Practice Address - Street 2:BROUSSARD CENTER FOR ATHLETIC TRAINING
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70803
Practice Address - Country:US
Practice Address - Phone:843-412-2785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program