Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 7758 | MN |
NPI | 1083839104 |
---|---|
Provider Name | Molly M Gross |
First Address | Golden Valley, MN 55422-4618 |
Second Address | Edina, MN 55439-2560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 02/04/2020 |