Individual
BENJAMIN GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
65 THOMAS JOHNSON DR, FREDERICK, MD 21702-4371
(240) 651-5280
Mailing address
1320 MOUNTAIN CHURCH RD, MIDDLETOWN, MD 21769-7313
(240) 676-3205
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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