Healthcare Provider Details

I. General information

NPI: 1033236468
Provider Name (Legal Business Name): GROSS THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 HWY 62 EAST, COLLEGE PLAZA
MOUNTAIN HOME AR
72653
US

IV. Provider business mailing address

P.O. BOX 2398
MOUNTAIN HOME AR
72654
US

V. Phone/Fax

Practice location:
  • Phone: 870-701-5089
  • Fax: 870-277-0896
Mailing address:
  • Phone: 870-404-5299
  • Fax: 870-277-0896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: KERRI MELISSA GROSS
Title or Position: VICE - PRESIDENT/CO-OWNER, GROSS TH
Credential: PT
Phone: 870-404-9368