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Contact Information

GAVIN GROSH
15946 N BULLARD AVE
SURPRISE, AZ85374-8844
 Phone: 816-382-5753
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for GAVIN GROSH · (Male)

NPI # 1306333182
Status Active
Credentials
Entity Individual
Enumeration date 04/17/2018
Last updated 04/17/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 1588
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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