Individual
DR. KELLY GOLDSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1 ILLINI DR, PEORIA, IL 61605-2576
(858) 444-7309
Mailing address
9505 E 203RD ST, PECULIAR, MO 64078-8792
(858) 444-7309
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125.076125
IL
Other
Enumeration date
05/07/2020
Last updated
05/07/2020
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