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Individual

TONYA S GROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
3525 AUGUSTUS RD, AIKEN, SC 29801-2701
(803) 642-8376
Mailing address
1142 MCCOYS CREEK RD, GROVETOWN, GA 30813-3832
(706) 726-8191
(706) 305-9287

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
3264
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100098417
WI
05
1841561446
SC
Enumeration date
03/02/2021
Last updated
03/02/2021
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