Provider Demographics
NPI:1598792392
Name:GRIFFITH, AMY CLAIRE (MS, ATC/L, CSCS)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:CLAIRE
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:MS, ATC/L, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1552 BARTLEY RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-8307
Mailing Address - Country:US
Mailing Address - Phone:706-302-3990
Mailing Address - Fax:
Practice Address - Street 1:221 WHITFIELD RD
Practice Address - Street 2:
Practice Address - City:HOGANSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30230-3209
Practice Address - Country:US
Practice Address - Phone:706-845-2070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0011552255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer