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General NPI Number Information
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NPI Number | 1427125475
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Entity Type | Individual
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Provider Name | HOLLY MARIE GROSS PT
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Gender | Female
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 730 E 34TH ST
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City | HIBBING
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State | MN
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Zip | 55746-5109
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Country | US
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Telephone | 218-262-3425
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Fax |
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Provider Business Mailing Address
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Address Line | 5211 HIGHWAY 110 ESSENTIA HEALTH NORTHERN PINES
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City | AURORA
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State | MN
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Zip | 55705-1522
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Country | US
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Telephone | 218-229-2211
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5727
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License Number State | MN
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