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STEPHANIE J GAINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4623 WESLEY AVE, STE C, CINCINNATI, OH 45212-2246
(513) 841-1122
Mailing address
8300 CHERRYDALE CT, MASON, OH 45040-9434
(513) 260-4604

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085-001999
IL
363A00000X
Physician Assistant
Primary
50-002897
OH

Other

Enumeration date
07/22/2009
Last updated
07/22/2009
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