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MR. JEREMY ALAN GROSS
>> Occupational Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1013489525
Individual Registrant:MR. JEREMY ALAN GROSS
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
1203 W ALEXANDER RD APT 5 VALLEY GROVE, WV 26060-8093 US
Tel: 304-280-7191 Fax: --
Tel: 304-280-7191 Fax: --
Contact information for business:
1203 W ALEXANDER RD APT 5 VALLEY GROVE, WV 26060-8093 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1013489525
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Occupational Therapy Assistant |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
