Individual
DR. CAROL GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2448 S 102ND ST, SUITE 270, WEST ALLIS, WI 53227-2466
(414) 543-9600
(414) 543-9601
Mailing address
312 EAST WISCONSIN AVENUE, SUITE 208, MILWAUKEE, WI 53202
(414) 731-0019
(414) 271-6433
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
036.119429
IL
172V00000X
Community Health Worker
Primary
25320-020
WI
Other
Enumeration date
12/11/2008
Last updated
12/11/2008
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