Individual
ELIZABETH GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
110 HORTON FIELDHOUSE, CAMPUS BOX 7130, NORMAL, IL 61790-0001
(309) 438-7246
Mailing address
2000 N LINDEN ST, APT H308, NORMAL, IL 61761-5321
(715) 579-7194
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003539
IL
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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