Provider Demographics
NPI:1750330494
Name:GRIFFITHS, NICHOLAS SPENCER (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:SPENCER
Last Name:GRIFFITHS
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 1:7343 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-1902
Mailing Address - Country:US
Mailing Address - Phone:313-582-1040
Mailing Address - Fax:313-582-3642
Practice Address - Street 1:7343 PARK AVE
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-1902
Practice Address - Country:US
Practice Address - Phone:313-582-1040
Practice Address - Fax:313-582-3642
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008167111NR0200X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4679057Medicaid
MIU90072Medicare UPIN
MI4679057Medicaid