Individual
STEPHEN GROSSERODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
488 S SAN VICENTE BLVD, LOS ANGELES, CA 90048-4107
(323) 655-9055
Mailing address
808 4TH ST APT 212, SANTA MONICA, CA 90403-1229
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
36953
CA
Other
Enumeration date
10/20/2010
Last updated
03/19/2013
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