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1871373910
DAVID RYAN GROSS
BREAUX BRIDGE, LA
NPI
1871373910
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA RAC-5079)
Enumeration Date
2023-10-05
Last Update Date
2023-10-05
Business Address
DAVID RYAN GROSS RAC
648 LATIOLAIS DR
BREAUX BRIDGE, LA 70517-4231
Phone number: 337-332-4878
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Mailing Address
DAVID RYAN GROSS RAC
124 JOMELA DR APT 9
LAFAYETTE, LA 70503-2547
Phone number:
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