Provider Demographics
NPI:1962494856
Name:GRIFFIN, ERIC D (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:D
Last Name:GRIFFIN
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 1:366 SOUTH WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883
Mailing Address - Country:US
Mailing Address - Phone:419-447-1861
Mailing Address - Fax:
Practice Address - Street 1:366 SOUTH WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883
Practice Address - Country:US
Practice Address - Phone:419-447-1861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH2539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2234059Medicaid
OHGR0839022Medicare PIN
OH2234059Medicaid