Provider Demographics
NPI:1063958510
Name:GRIFFIN, CAROLYN (DC)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2809
Mailing Address - Country:US
Mailing Address - Phone:314-566-4282
Mailing Address - Fax:
Practice Address - Street 1:222 S 2ND ST
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2809
Practice Address - Country:US
Practice Address - Phone:314-566-4282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016039200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor