Healthcare Provider Details

I. General information

NPI: 1700118437
Provider Name (Legal Business Name): JULIE GROSS DC, MSACN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2010
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9276 MAIN ST STE 3B
CLARENCE NY
14031-1969
US

IV. Provider business mailing address

PO BOX 67
CLARENCE NY
14031-0067
US

V. Phone/Fax

Practice location:
  • Phone: 716-759-4950
  • Fax: 716-759-4955
Mailing address:
  • Phone: 716-759-4950
  • Fax: 716-759-4955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX011703-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: