Basic Information
| Provider Information | |||||||||
| NPI: | 1225368061 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GROFF | ||||||||
| FirstName: | CASSIE | ||||||||
| MiddleName: | JANE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BRAEGELMANN | ||||||||
| OtherFirstName: | CASSIE | ||||||||
| OtherMiddleName: | JANE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | II | ||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | P.O. BOX 209036 | ||||||||
| Address2: | SHRINERS HOSPITALS FOR CHILDREN @ TWIN CITIES | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753209036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132818478 | ||||||||
| FaxNumber: | 8132818113 | ||||||||
| Practice Location | |||||||||
| Address1: | 2025 E RIVER PARKWAY | ||||||||
| Address2: | SHRINERS HOSPITAL FOR CHILDREN | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6125966100 | ||||||||
| FaxNumber: | 6123395954 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2009 | ||||||||
| LastUpdateDate: | 03/28/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251P0200X | #6699 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics |
No ID Information.