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Individual

MS. ANDREA GRACE GROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
1120 S UTICA AVE, TULSA, OK 74104-4090
(918) 579-7100
Mailing address
1120 S UTICA AVE, TULSA, OK 74104-4090
(918) 579-7100

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5230
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15057148
CAQH
Enumeration date
07/17/2019
Last updated
01/12/2021
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