Individual
CARLY LENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1802 W PARKSIDE LN, PHOENIX, AZ 85027-1322
(602) 943-5472
Mailing address
7228 W PONTIAC DR, GLENDALE, AZ 85308-9628
(623) 866-3035
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7139
AZ
Other
Enumeration date
08/17/2015
Last updated
08/17/2015
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