Provider Demographics
NPI:1396747226
Name:GRIFFIN, LYNN E (DC)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:E
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 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-3007
Practice Address - Country:US
Practice Address - Phone:419-447-1861
Practice Address - Fax:419-447-1498
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH502111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0262988Medicaid
OHGR0409902Medicare ID - Type Unspecified
OH0262988Medicaid