MEDICARE: TIMOTHY GROSS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHIR007666	GA

General Provider Information

NPI Number	:	1164266458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY GROSS DC

Provider Business Mailing Address
First Line	:	1651 MILFORD CREEK OVERLOOK SW
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30008-8108
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1323 ROSWELL RD
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-3667
Country	:	US
Telephone Number	:	770-476-2056
Fax Number	:	770-794-3038

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2024
Last Update Date	:	12/14/2025

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Directions to “ TIMOTHY GROSS DC” Practice Location

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