Provider Demographics
NPI:1831963495
Name:LOVE, GRIFFIN N (DPT)
Entity type:Individual
Prefix:
First Name:GRIFFIN
Middle Name:N
Last Name:LOVE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9045 BLUE DASHER DR
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-4419
Mailing Address - Country:US
Mailing Address - Phone:704-451-3949
Mailing Address - Fax:
Practice Address - Street 1:439 CHANNEL RD
Practice Address - Street 2:
Practice Address - City:CLOVER
Practice Address - State:SC
Practice Address - Zip Code:29710-6102
Practice Address - Country:US
Practice Address - Phone:804-746-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12211225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist