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Individual

BRIAN DANIEL GROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMP

Contact information

Practice address
12506 18TH ST NE, LAKE STEVENS, WA 98258-8145
(425) 334-5409
Mailing address
12506 18TH ST NE, LAKE STEVENS, WA 98258-8145
(425) 334-5409

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60438589
WA

Other

Enumeration date
11/25/2014
Last updated
11/25/2014
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