Individual
TAMMY MICHELE GROSS-MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1045 S LA GRANGE RD, LA GRANGE, IL 60525-2846
(708) 579-4220
Mailing address
5609 S AUSTIN AVE, CHICAGO, IL 60638-3501
(773) 884-1811
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.001553
IL
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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