Provider Demographics
NPI:1205065042
Name:GRIFFITH, VICTORIA KANGETER (DPT)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:KANGETER
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 W. RUSTIN STREET
Mailing Address - Street 2:
Mailing Address - City:GLENNVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30427-1805
Mailing Address - Country:US
Mailing Address - Phone:912-654-2385
Mailing Address - Fax:912-654-2394
Practice Address - Street 1:104 W RUSTIN STREET
Practice Address - Street 2:
Practice Address - City:GLENNVILLE
Practice Address - State:GA
Practice Address - Zip Code:30427-1805
Practice Address - Country:US
Practice Address - Phone:912-654-2385
Practice Address - Fax:912-654-2394
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009669225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist