Provider Demographics
NPI:1144323197
Name:ROHOLT, PATRICIA (PT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:ROHOLT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12826 NEVADA CITY HWY
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-3107
Mailing Address - Country:US
Mailing Address - Phone:612-730-7776
Mailing Address - Fax:530-272-2990
Practice Address - Street 1:857 SUTTON WAY
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5178
Practice Address - Country:US
Practice Address - Phone:530-272-4284
Practice Address - Fax:530-272-2990
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38651225100000X
MN18182251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports