Individual
SHAUN GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
14 MAPLE ST STE 120, GILFORD, NH 03249-6580
(603) 524-2852
Mailing address
80 HIGHLAND ST, LACONIA, NH 03246-3235
(603) 524-3211
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
882
NH
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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