Provider Demographics
NPI:1396483947
Name:GRIFFITH, KAYNE (DC)
Entity type:Individual
Prefix:
First Name:KAYNE
Middle Name:
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2860 10TH AVE N STE 200
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58203-2275
Mailing Address - Country:US
Mailing Address - Phone:701-757-1145
Mailing Address - Fax:701-757-1156
Practice Address - Street 1:2860 10TH AVE N STE 200
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58203-2275
Practice Address - Country:US
Practice Address - Phone:701-757-1145
Practice Address - Fax:701-757-1156
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor