Healthcare Provider Details

I. General information

NPI: 1427228071
Provider Name (Legal Business Name): VERA JUNE GROFF CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2008
Last Update Date: 03/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 4TH ST STE A
SANTA ROSA CA
95404-4538
US

IV. Provider business mailing address

1970 BARNDANCE LN
SANTA ROSA CA
95407-4548
US

V. Phone/Fax

Practice location:
  • Phone: 707-526-4737
  • Fax:
Mailing address:
  • Phone: 707-526-4737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175L00000X
TaxonomyHomeopath
License NumberCERTIFIED
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: