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1104979582
PROVIDENCE FAMILY PRACTICE MEDICAL GROUP
MODESTO, CA
NPI
1104979582
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Entity Type
Organization
Authorized Contact
KATHIE LEE CRONIN
Managing Partner
209-491-2500
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2007-01-19
Last Update Date
2020-08-22
Business Address
PROVIDENCE FAMILY PRACTICE MEDICAL GROUP
1213 COFFEE RD SUITE B
MODESTO, CA 95355-4229
Phone number: 209-491-2500
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Mailing Address
PROVIDENCE FAMILY PRACTICE MEDICAL GROUP
1213 COFFEE RD SUITE B
MODESTO, CA 95355-4229
Phone number: 209-491-2500
Copy
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