Individual
JACOB GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 HARMON HTS, STANFORD, KY 40484-1111
(606) 369-2141
Mailing address
79 NORWOOD DR, SCIENCE HILL, KY 42553-9325
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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