Provider Demographics
NPI:1609895788
Name:GRIFFIN, MICHAEL J (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:MICHAEL
Other - Middle Name:J
Other - Last Name:TRUMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:6871 W. 91ST ST.
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212
Mailing Address - Country:US
Mailing Address - Phone:913-381-0740
Mailing Address - Fax:913-381-0738
Practice Address - Street 1:FUNCTIONAL HEALTH KC
Practice Address - Street 2:6871 W. 91ST ST.
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212
Practice Address - Country:US
Practice Address - Phone:913-381-0740
Practice Address - Fax:913-381-0738
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4890111N00000X
KS01-04890111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS4402259OtherUNITED HEALTH CARE #
KS34117017OtherBLUE CROSS BLUE SHIELD #
KSR62D074Medicare ID - Type UnspecifiedMEDICARE #