Detric Griffin

NPI #1487007167 in Kosciusko, Mississippi

Provider Information

NPI Number: 1487007167
Entity Type: Individual
Name: Detric Griffin
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Jul 19, 2016
Last Updated: Jul 19, 2016

Practice Location

Address: 2191 ATTALA ROAD 1006
City: Kosciusko
State: Mississippi
ZIP Code: 39090-6146
Phone: (662) 739-1320

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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