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Individual

KELLY HUME

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
3305 E FRY BLVD, SIERRA VISTA, AZ 85635-2990
(520) 515-2754
Mailing address
26 PRONGHORN LN, ELGIN, AZ 85611-7512
(760) 275-5597

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT31585
AZ
2251P0200X
Pediatric Physical Therapist
26604
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LPT31585
PT
AZ
01
PT26604
LICENSE #
CA
Enumeration date
02/27/2007
Last updated
09/24/2025
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