Individual
MR. DAVID ROBERT GROSS
Active
Individual
MR. DAVID ROBERT GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5464
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201568
LABOR AND INDUSTRY
WA
01
—
1136229
CAQH
—
01
—
167753167755
PREMERA
WA
01
—
5623609
FIRST HEALTH
WA
01
—
60607
FIRST CHOICE
WA
01
—
7775192
AETNA
—
Enumeration date
10/06/2006
Last updated
08/20/2010
Update your record
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