Provider Demographics
NPI:1902680762
Name:MEYERS, GRIFFIN (PT)
Entity Type:Individual
Prefix:
First Name:GRIFFIN
Middle Name:
Last Name:MEYERS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 WOOTTON STREET
Mailing Address - Street 2:UNITS I AND J
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005
Mailing Address - Country:US
Mailing Address - Phone:973-794-6040
Mailing Address - Fax:
Practice Address - Street 1:315 WOOTTON STREET
Practice Address - Street 2:UNITS I AND J
Practice Address - City:BOONTON
Practice Address - State:NJ
Practice Address - Zip Code:07005
Practice Address - Country:US
Practice Address - Phone:973-794-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist