Provider Demographics
NPI:1932983582
Name:SUMMIT, GRIFFIN
Entity Type:Individual
Prefix:MR
First Name:GRIFFIN
Middle Name:
Last Name:SUMMIT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7954 TOWNSHIP ROAD 93
Mailing Address - Street 2:
Mailing Address - City:CAREY
Mailing Address - State:OH
Mailing Address - Zip Code:43316-9639
Mailing Address - Country:US
Mailing Address - Phone:419-722-1992
Mailing Address - Fax:
Practice Address - Street 1:2820 GREENACRE DR
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-4157
Practice Address - Country:US
Practice Address - Phone:419-424-1808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH013359225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant