Provider Demographics
NPI:1871737437
Name:GROFF, DEBORAH (PT)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:GROFF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:13167-3118
Mailing Address - Country:US
Mailing Address - Phone:315-668-8709
Mailing Address - Fax:315-668-8709
Practice Address - Street 1:35 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:NY
Practice Address - Zip Code:13167-3118
Practice Address - Country:US
Practice Address - Phone:315-668-8709
Practice Address - Fax:315-668-8709
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011008-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist