# DR. STAN M GROSS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1538206081
- **Gender:** Man
- **Credential:** DC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | CE00005721 | MO | Yes |

## Other

- **Enumeration date:** 01/31/2007
- **Last updated:** 06/23/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1538206081 | NPI | MO |
| 01 | — | 991666007 | PTAN | MO |