Provider Demographics
NPI:1962277533
Name:GROSSI, JOHN ANTHONY (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ANTHONY
Last Name:GROSSI
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 ASHLEY MARIA CT
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-6381
Mailing Address - Country:US
Mailing Address - Phone:850-217-6589
Mailing Address - Fax:
Practice Address - Street 1:2706 ASHLEY MARIA CT
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-6381
Practice Address - Country:US
Practice Address - Phone:850-217-6589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-23
Last Update Date:2023-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT166932081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine