Individual
KELLY ANDREW LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2300 S HOUGHTON RD STE 160, TUCSON, AZ 85748-0046
(520) 352-1083
(520) 352-1088
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
64112
AZ
208600000X
Surgery Physician
A148544
CA
Other
Enumeration date
03/27/2015
Last updated
08/23/2025
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