Individual
JONATHAN GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3169 12TH AVE SE, HICKORY, NC 28602-9666
(704) 325-3202
Mailing address
430 9TH ST NW, HICKORY, NC 28601-3524
(919) 616-5775
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-07197
NC
363AM0700X
Medical Physician Assistant
00107197
NC
Other
Enumeration date
04/20/2017
Last updated
11/02/2022
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