Individual
JESSICA GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6089 W MAPLE RD STE 200, WEST BLOOMFIELD, MI 48322-2286
(248) 851-1600
(248) 851-0421
Mailing address
3758 GRIFFITH AVE APT SUITE, BERKLEY, MI 48072-1439
(248) 930-6134
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601010866
MI
Other
Enumeration date
09/21/2020
Last updated
12/17/2022
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