Provider Demographics
NPI:1568653228
Name:GRIFFITH, ROBERT R (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-3111
Mailing Address - Country:US
Mailing Address - Phone:937-372-6367
Mailing Address - Fax:
Practice Address - Street 1:170 E MARKET ST
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-3111
Practice Address - Country:US
Practice Address - Phone:937-372-6367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHGRO394691Medicare PIN