Provider Demographics
NPI:1528413036
Name:GRIFFIN, VICTOR LEE (ATC)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:LEE
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5132 ASPEN PINE BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9331
Mailing Address - Country:US
Mailing Address - Phone:704-280-9881
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY TER
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-6816
Practice Address - Country:US
Practice Address - Phone:704-280-9881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer