Individual
HOLLY SPOHN-GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
6425 LYNCH CANYON DR, LAKE ISABELLA, CA 93240-9726
(760) 379-8630
(760) 379-7658
Mailing address
6425 LYNCH CANYON DR, LAKE ISABELLA, CA 93240-9726
(760) 379-8630
(760) 379-7658
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4349
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213E00000X
TAXONOMY
CA
01
—
E4349
STATE LICENSE
CA
Enumeration date
10/19/2006
Last updated
01/18/2024
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