Healthcare Provider Details

I. General information

NPI: 1831008457
Provider Name (Legal Business Name): SAMUEL J GROS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3405 NW HUNTERS RIDGE TER STE 300
TOPEKA KS
66618-2510
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 785-246-2300
  • Fax:
Mailing address:
  • Phone: 423-238-7217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number14-04449
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: