Individual
DR. STAN M GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CE00005721
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538206081
NPI
MO
01
—
991666007
PTAN
MO
Enumeration date
01/31/2007
Last updated
06/23/2015
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