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Individual

KELLY COLLEEN FARRELL MOFFITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
2600 N. WYATT DR., TUCSON, AZ 85712-6106
(520) 324-3027
(520) 324-3128
Mailing address
2600 N. WYATT DR., TUCSON, AZ 85712-6106
(520) 324-3027
(520) 324-3128

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0014057
CO
225100000X
Physical Therapist
Primary
LPT-012573
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
552763
AZ
Enumeration date
07/08/2016
Last updated
02/12/2022
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