Provider Demographics
NPI:1528664463
Name:GRIFFIN, PATRICK J SR
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:J
Last Name:GRIFFIN
Suffix:SR
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 1:8000 MISSION ROAD
Mailing Address - Street 2:
Mailing Address - City:ST.MICHAELS
Mailing Address - State:ND
Mailing Address - Zip Code:58370
Mailing Address - Country:US
Mailing Address - Phone:701-766-1960
Mailing Address - Fax:
Practice Address - Street 1:8000 MISSION RD UNIT 80
Practice Address - Street 2:
Practice Address - City:ST.MICHALS
Practice Address - State:ND
Practice Address - Zip Code:57701
Practice Address - Country:US
Practice Address - Phone:701-766-1960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant