Individual
MARILYN GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
800 COTTAGE GROVE RD, BLOOMFIELD, CT 06002-3064
(860) 243-6571
(860) 243-6579
Mailing address
800 COTTAGE GROVE RD, BLOOMFIELD, CT 06002-3064
(860) 243-6571
(860) 243-6579
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006830
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080006830CT02
BCBS PROVIDER NUMBER
CT
Enumeration date
01/17/2007
Last updated
07/08/2007
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