Provider Demographics
NPI:1700165065
Name:POLITO, ELIZABETH RACHEL GROFF (PT, DPT, OCS, ATC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH RACHEL
Middle Name:GROFF
Last Name:POLITO
Suffix:
Gender:F
Credentials:PT, DPT, OCS, ATC
Other - Prefix:
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Mailing Address - Street 1:1129 11TH ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DYERSVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52040
Mailing Address - Country:US
Mailing Address - Phone:563-875-8615
Mailing Address - Fax:563-875-8722
Practice Address - Street 1:1129 11TH ST SE
Practice Address - Street 2:SUITE A
Practice Address - City:DYERSVILLE
Practice Address - State:IA
Practice Address - Zip Code:52040
Practice Address - Country:US
Practice Address - Phone:563-875-8615
Practice Address - Fax:563-875-8722
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA004736225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist