Provider Demographics
NPI:1184907248
Name:GRIFFIN SPINE CENTER INC
Entity type:Organization
Organization Name:GRIFFIN SPINE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:DINOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-467-8144
Mailing Address - Street 1:128 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-3332
Mailing Address - Country:US
Mailing Address - Phone:770-467-8144
Mailing Address - Fax:678-603-1102
Practice Address - Street 1:128 N 5TH ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-3332
Practice Address - Country:US
Practice Address - Phone:770-467-8144
Practice Address - Fax:678-603-1102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2593111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA091481544AMedicare PIN