KELLY GAINES

MODESTO, CA
NPI1225320211
Former NameKELLY SMITH
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: CA  17770)
Enumeration Date2011-05-09
Last Update Date2011-05-09
Business Address
-- KELLY GAINES FNP
1213 COFFEE RD
MODESTO, CA 95355-4229
Phone number: 209-491-2500
Mailing Address
-- KELLY GAINES FNP
1213 COFFEE RD
MODESTO, CA 95355-4229
Phone number: 209-491-2500
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