Provider Demographics
NPI:1124774377
Name:GROFF, RACHEL EVELYN (OD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:EVELYN
Last Name:GROFF
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8956 W LUKE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-2274
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12801 W BELL RD STE 139
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-9734
Practice Address - Country:US
Practice Address - Phone:623-583-0377
Practice Address - Fax:623-583-0378
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3728152W00000X
AZOPT-002738152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist