Provider Demographics
NPI:1215687462
Name:GRIFFITHS, BRETT
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:GRIFFITHS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2943 E CANYON CREST DR
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-8936
Mailing Address - Country:US
Mailing Address - Phone:208-240-7178
Mailing Address - Fax:
Practice Address - Street 1:42 E 300 N
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1859
Practice Address - Country:US
Practice Address - Phone:801-896-1961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT60522OtherUTAH