Provider Demographics
NPI:1508815523
Name:GRIFFIS, SASHA R (DC)
Entity Type:Individual
Prefix:MRS
First Name:SASHA
Middle Name:R
Last Name:GRIFFIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MISS
Other - First Name:SASHA
Other - Middle Name:R
Other - Last Name:CRITES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:79 HILLSDALE ST
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-1208
Mailing Address - Country:US
Mailing Address - Phone:517-439-9800
Mailing Address - Fax:517-439-1230
Practice Address - Street 1:79 HILLSDALE ST
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-1208
Practice Address - Country:US
Practice Address - Phone:517-439-9800
Practice Address - Fax:517-439-1230
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009041111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950C06053OtherBCBS
MI4846048Medicaid
MI950C06053OtherBCBS
MIC06053007Medicare ID - Type Unspecified