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NPI Code Detail

MEDICARE: MRS. JULIE A. DEGROFF OTR/L

MEDICARE: MRS. JULIE A. DEGROFF OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist3974AZ
2225X00000XOccupational Therapist056.003789IL

General Provider Information

NPI Number : 1437253945
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JULIE A. DEGROFF OTR/L
Provider Business Mailing Address
First Line : 2483 N STRAWBERRY WAY
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-7614
Country : US
Telephone Number : 928-600-0170
Fax Number :
Provider Business Practice Location Address
First Line : 3150 N WINDING BROOK RD
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-0972
Country : US
Telephone Number : 928-774-7106
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 10/01/2012

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