Individual
TERESA LYNNE GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2130 W SYCAMORE ST, KOKOMO, IN 46901-4122
(765) 263-8500
Mailing address
12134 N 350 W, ALEXANDRIA, IN 46001-8547
(812) 630-7818
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002670A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0600267A
PTA LICENSE
IN
Enumeration date
04/30/2010
Last updated
01/16/2026
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