Provider Demographics
NPI:1710580188
Name:GRIFFITHS, SAMUEL LEE (DPT)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:LEE
Last Name:GRIFFITHS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 N 118TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-3643
Mailing Address - Country:US
Mailing Address - Phone:408-252-4792
Mailing Address - Fax:402-625-0417
Practice Address - Street 1:501 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:LONE PINE
Practice Address - State:CA
Practice Address - Zip Code:93545-8044
Practice Address - Country:US
Practice Address - Phone:760-878-5501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT299290225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist