Individual
KELLY A LAYNE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5501 N ORACLE RD, TUCSON, AZ 85704-3829
(520) 293-5551
(520) 293-6638
Mailing address
5501 N ORACLE RD, TUCSON, AZ 85704-3850
(520) 293-5551
(520) 293-6638
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86059251885705C021
TRICARE PROVIDER NUMBER
AZ
Enumeration date
08/17/2005
Last updated
07/08/2007
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