Provider Demographics
NPI:1205860343
Name:GROSS, LAURA S (DC)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:S
Last Name:GROSS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4170 HAYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MILLS RIVER
Mailing Address - State:NC
Mailing Address - Zip Code:28759-9740
Mailing Address - Country:US
Mailing Address - Phone:828-891-8868
Mailing Address - Fax:828-891-8897
Practice Address - Street 1:4170 HAYWOOD RD
Practice Address - Street 2:
Practice Address - City:MILLS RIVER
Practice Address - State:NC
Practice Address - Zip Code:28759-9740
Practice Address - Country:US
Practice Address - Phone:828-891-8868
Practice Address - Fax:828-891-8897
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC2083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0846ROtherNC STATE HEALTH PLAN
NC0846ROtherBLUE CROSS OF NC
NC890846RMedicaid
U55305Medicare UPIN
NC890846RMedicaid