Individual
JEFFERY ROBERT GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1376 SILVER SPRINGS DR, LEXINGTON, KY 40511-2319
(859) 277-0320
Mailing address
43 GROSS LOOP, JACKSON, KY 41339-8625
(606) 272-1969
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A02416
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
N/A
—
Enumeration date
06/26/2018
Last updated
06/26/2018
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