Provider Demographics
NPI:1932237567
Name:GRIFFITH, LEIGH JAMES (PT,CMP)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:JAMES
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:PT,CMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7145 COUNTY ROAD 1
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:ND
Mailing Address - Zip Code:58018-9639
Mailing Address - Country:US
Mailing Address - Phone:612-850-3988
Mailing Address - Fax:
Practice Address - Street 1:4801 SOUTHWICK DR
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-2254
Practice Address - Country:US
Practice Address - Phone:708-283-9765
Practice Address - Fax:708-283-9971
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.015637225100000X
MN7451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist