Provider Demographics
NPI:1760084511
Name:GRIFFITH, JOSEPH LANCE (LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:LANCE
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 HARVEY ST
Mailing Address - Street 2:
Mailing Address - City:MILLEN
Mailing Address - State:GA
Mailing Address - Zip Code:30442-1671
Mailing Address - Country:US
Mailing Address - Phone:912-536-1484
Mailing Address - Fax:
Practice Address - Street 1:433 BARNEY AVE
Practice Address - Street 2:
Practice Address - City:MILLEN
Practice Address - State:GA
Practice Address - Zip Code:30442-1903
Practice Address - Country:US
Practice Address - Phone:912-536-1484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0008312255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer