Individual
CANDACE M GROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1004 10TH ST, PORT ROYAL, SC 29935-2310
(843) 379-2601
(800) 317-9690
Mailing address
1004 10TH ST, PORT ROYAL, SC 29935-2310
(843) 379-2601
(800) 317-9690
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
03/01/2007
Last updated
02/05/2012
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