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Howard Griffin

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NPI Number Detailed Information

Provider Information:

Name: Howard Griffin
Gender: M
Provider License Number If Given: 13041

NPI Information:

NPI: 1669467122
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 11/23/2007

Provider Business Mailing Address:

Address: PO BOX 938
Waycross, GA 31502
Phone Number: 9122871515
Fax Number: 9122871394

Provider Business Practice Location Address:

Address: 410 DARLING AVE
Waycross, GA 31501
Phone Number: 9122871515
Fax Number: 9122871394

Provider Taxonomy:

Primary: 2085R0202X
Secondary (if any):
State: GA

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