Individual
KELLY W GULICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6391 LANCASTER RD, HEBRON, OH 43025-9779
(740) 403-4994
Mailing address
6391 LANCASTER RD, HEBRON, OH 43025-9779
(740) 403-4994
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RH054146
ODL
OH
Enumeration date
12/28/2020
Last updated
12/28/2020
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