Doctor Name: | ARIEL L GROSS |
NPI Number: | 1033472220 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 156936 |
Business Practice Address: | 202 Conway Dr Suite 200 Kalispell, MT - 599013153 |
Business Phone Number: | 4067528433 |
Business Fax Number: | 4067566768 |
Mailing Address: | 202 Conway Dr, Suite 200 KALISPELL |
State: | MT |
Postal Code: | 599013153 |
Phone Number: | 4067528433 |
Fax Number: | 4067566768 |
NPI Enumeration Date: | 06/21/2012 |
NPI Last Update Date: | 04/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 156936 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |