Provider Demographics
NPI:1902454598
Name:GRIFFIN, DANIEL IV (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:GRIFFIN
Suffix:IV
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 SHOEMAKER LN
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-3620
Mailing Address - Country:US
Mailing Address - Phone:781-910-9974
Mailing Address - Fax:
Practice Address - Street 1:470 SHOEMAKER LN
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-3620
Practice Address - Country:US
Practice Address - Phone:781-910-9974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24530208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation