Individual
KELLY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1626 N LITCHFIELD RD STE 310, GOODYEAR, AZ 85395-1397
(623) 680-0036
Mailing address
7602 N 185TH AVE, WADDELL, AZ 85355-9815
(623) 680-0036
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
31672
AZ
Other
Enumeration date
03/25/2021
Last updated
03/25/2021
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