Individual
DR. KYRA DE LA FUENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
20325 N 51ST AVE STE 148, GLENDALE, AZ 85308-4610
(623) 249-3216
Mailing address
2046 W DAVIS RD, PHOENIX, AZ 85023-7207
(314) 591-5694
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/03/2024
Last updated
08/03/2024
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