Provider Demographics
NPI:1912148479
Name:GRIFFETH, DENNIS RYAN (DC,)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:RYAN
Last Name:GRIFFETH
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 1:821 N ALTA VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-3140
Mailing Address - Country:US
Mailing Address - Phone:208-890-2072
Mailing Address - Fax:
Practice Address - Street 1:821 N ALTA VIEW DR
Practice Address - Street 2:
Practice Address - City:SARATOGA SPGS
Practice Address - State:UT
Practice Address - Zip Code:84045-3140
Practice Address - Country:US
Practice Address - Phone:208-890-2072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11819210-1202111N00000X
IDCHIA-1358111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID26-43100111OtherEMPLOYER IDENTIFICATION NUMBER