Individual
JOHN R GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT-I
Contact information
Practice address
1 COLVILLE STREET, NESPELEM, WA 99155
(509) 634-2727
(509) 634-2781
Mailing address
1 COLVILLE STREET, NESPELEM, WA 99155
(509) 634-2727
(509) 634-2781
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
0106226
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9545807
—
WA
Enumeration date
05/18/2007
Last updated
07/09/2007
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