Individual
KRISTI REBECCA GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST, CSFA
Contact information
Practice address
1101 OCILLA RD, DOUGLAS, GA 31533-2207
(912) 384-1900
Mailing address
58 FLINT DR, DOUGLAS, GA 31533-7460
(912) 383-4502
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
170803
GA
246ZX2200X
Orthopedic Assistant
170803
GA
Other
Enumeration date
12/02/2016
Last updated
12/02/2016
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