Individual
MR. MATTHEW GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
4150 5TH ST, RAPID CITY, SD 57701-6022
(605) 755-4300
Mailing address
1115 SITKA ST, RAPID CITY, SD 57701-2085
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP001253
SD
Other
Enumeration date
08/17/2017
Last updated
03/17/2018
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