Individual
MR. JEREMY ALAN GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1203 W ALEXANDER RD APT 5, VALLEY GROVE, WV 26060-8093
(304) 280-7191
Mailing address
1203 W ALEXANDER RD APT 5, VALLEY GROVE, WV 26060-8093
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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