Provider Demographics
NPI:1487697702
Name:GRIFFIN, DORCUS LAYATTA (RKT)
Entity type:Individual
Prefix:MRS
First Name:DORCUS
Middle Name:LAYATTA
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:RKT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 CITY PARK CIR
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-4934
Mailing Address - Country:US
Mailing Address - Phone:601-544-0797
Mailing Address - Fax:
Practice Address - Street 1:133 CITY PARK CIR
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-4934
Practice Address - Country:US
Practice Address - Phone:601-544-0797
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1642226300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist