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General NPI Number Information
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NPI Number | 1164266458
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Entity Type | Individual
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Provider Name | TIMOTHY GROSS DC
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Gender | Male
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Dates
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Enumeration Date | 06/21/2024
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Last Update Date | 12/14/2025
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Provider Practice Location Address
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Address Line | 1323 ROSWELL RD
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City | MARIETTA
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State | GA
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Zip | 30062-3667
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Country | US
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Telephone | 770-476-2056
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Fax | 770-794-3038
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Provider Business Mailing Address
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Address Line | 1651 MILFORD CREEK OVERLOOK SW
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City | MARIETTA
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State | GA
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Zip | 30008-8108
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIR007666
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License Number State | GA
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