Individual
BENJAMIN JEFFREY GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1190 E MISSOURI AVE, STE 100, PHOENIX, AZ 85014-2734
(602) 393-0520
Mailing address
3915 N 54TH WAY, PHOENIX, AZ 85018-4537
(412) 913-7839
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4648
AZ
Other
Enumeration date
07/17/2012
Last updated
07/17/2012
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