Individual
LEO GROSS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5597 NW 50TH ST APT 5597B, WARR ACRES, OK 73122-5232
(405) 227-3293
Mailing address
5597 NW 50TH ST APT 5597B, WARR ACRES, OK 73122-5232
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
OK
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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