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Individual

TEVIN GRIFFIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
301 E MIEL DE LUNA AVE, TUCUMCARI, NM 88401-3810
(575) 461-7230
Mailing address
3908 N 110TH PLZ, OMAHA, NE 68164-2846
(402) 452-7410

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
1598
NE
225200000X
Physical Therapy Assistant
Primary
PTA1459
NM

Other

Enumeration date
11/06/2017
Last updated
11/06/2017
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