Individual
GREGORY GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8310 W USTICK RD STE 100, BOISE, ID 83704-6038
(208) 912-6986
Mailing address
8310 W USTICK RD STE 100, BOISE, ID 83704-6038
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/14/2023
Last updated
07/14/2023
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