Most Relevant Information
Provider Data
| NPI Number: | 1003493602 |
| Provider Name: | MICHAEL GROSS |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/28/2021 |
| Last Updated: | 03/28/2021 |
Provider Practice Location
1 MEDICAL DR DEPT OF
LEBANON
NH
037561000
Practice Location Phone/Fax
| Phone: | 6036505000 |
| Fax: |
Provider Mailing Location
1 MEDICAL DR DEPT OF
LEBANON
NH
037561000
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |