Doctor Name: | TIMOTHY I GROSS |
NPI Number: | 1073971867 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 61543 |
Business Practice Address: | 425 N Main St Prineville, OR - 977541855 |
Business Phone Number: | 5414167476 |
Business Fax Number: | 5414167478 |
Mailing Address: | 805 Sw Industrial Way, Suite 3 BEND |
State: | OR |
Postal Code: | 977021118 |
Phone Number: | 5415852529 |
Fax Number: | 5415852536 |
NPI Enumeration Date: | 02/08/2016 |
NPI Last Update Date: | 02/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 61543 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |