Provider Demographics
NPI:1932316148
Name:GRIFFIN, JOSH ERIC (MED, ATC)
Entity Type:Individual
Prefix:MR
First Name:JOSH
Middle Name:ERIC
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 EMERY CV
Mailing Address - Street 2:APT #25
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-7492
Mailing Address - Country:US
Mailing Address - Phone:501-860-1427
Mailing Address - Fax:
Practice Address - Street 1:8907 KANIS RD
Practice Address - Street 2:SUITE 400
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6449
Practice Address - Country:US
Practice Address - Phone:501-663-4320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAT 3892255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer