Basic Information
Provider Information
NPI: 1043584576
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRIFFITHS
FirstName: JATHAN
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 306393
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372306393
CountryCode: US
TelephoneNumber: 6153731350
FaxNumber: 6153737116
Practice Location
Address1: 110 SAINT BLAISE RD STE 101
Address2:  
City: GALLATIN
State: TN
PostalCode: 370664442
CountryCode: US
TelephoneNumber: 6154420400
FaxNumber: 6154420401
Other Information
ProviderEnumerationDate: 03/01/2012
LastUpdateDate: 05/17/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/17/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X14179TNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000XPT 33052CAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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