Individual
KELLY ANN SHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-1000
Mailing address
2108 E THOMAS RD, PHOENIX, AZ 85016-7761
(602) 933-3124
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
40QA01549100
NJ
225100000X
Physical Therapist
Primary
LPT-32277
AZ
Other
Enumeration date
10/27/2014
Last updated
10/18/2023
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