Individual
GAIL LYNNE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 MELROSE DR LOT 244, WOOSTER, OH 44691-1864
(330) 988-4678
Mailing address
4400 MELROSE DR LOT 244, WOOSTER, OH 44691-1864
(330) 988-4678
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851903
—
OH
Enumeration date
12/26/2022
Last updated
12/26/2022
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