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Individual

BRADLEY M GRIFFIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
1111 LEFFINGWELL AVE NE, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
(616) 464-6170
Mailing address
1111 LEFFINGWELL AVE NE, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
(616) 464-6170

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010066
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5201010066
STATE OF MICHIGAN LICENSING
MI
Enumeration date
12/13/2017
Last updated
12/13/2017
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