Individual
MR. EDWARD GRIFFIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC/LAT
Contact information
Practice address
4100 GARY ST, FORT SMITH, AR 72903-5456
(479) 629-3264
Mailing address
2712 CANTERBURY CIR, FORT SMITH, AR 72903-5259
(479) 629-3264
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
153
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
153
LIC. ATHLETIC TRAINER
AR
Enumeration date
04/15/2014
Last updated
04/15/2014
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