Individual
TAMMY JEAN GROSSERODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5330 N OAK TRFY, SUITE 200, KANSAS CITY, MO 64118-4699
(816) 454-0666
(816) 454-1694
Mailing address
5810 NW BARRY RD, STE 100, KANSAS CITY, MO 64154-1400
(816) 454-0666
(816) 454-1694
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2006024407
MO
Other
Enumeration date
02/06/2008
Last updated
07/16/2019
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