Provider Demographics
NPI:1447029426
Name:GRIFFIN, JOHN DYLAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:DYLAN
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 WALLACE ST
Mailing Address - Street 2:
Mailing Address - City:WHITEWRIGHT
Mailing Address - State:TX
Mailing Address - Zip Code:75491-2716
Mailing Address - Country:US
Mailing Address - Phone:903-821-1202
Mailing Address - Fax:
Practice Address - Street 1:3811 N US HIGHWAY 75 STE 100
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2580
Practice Address - Country:US
Practice Address - Phone:903-838-8882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1295401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist