Individual
MR. RONALD EUGENE GROSSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
KT/CEP
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 424-6053
Mailing address
240 OCKLEY DR, SHREVEPORT, LA 71105-3025
(318) 219-7672
Taxonomy
Speciality
Code
Description
License number
State
226300000X
Kinesiotherapist
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CEP.CE0132
EXERCISE PHYSIOLOGIST
LA
Enumeration date
05/26/2006
Last updated
11/02/2007
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