Lonnie Gross Jr., ATC
Specialist/Technologist, Athletic Trainer in Blacksburg, VA. Individual provider (NPI-1).
NPI number1982129391
StatusActive
Last updated in NPPESAug 7, 2017
Details
- NPI
- 1982129391
- Entity type
- Individual (NPI-1)
- Name
- Mr. Lonnie Gross Jr.
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 7, 2017
- Last updated
- Aug 7, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
325 Stranger StBlacksburg, VA 24061-0001
Phone 540-815-4336
Mailing address
402 Vincent St NwRoanoke, VA 24012-1522
Phone 540-815-4336
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