Individual
KIA CLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
14300 W GRANITE VALLEY DR STE E21, SUN CITY WEST, AZ 85375-5798
(623) 546-6712
(623) 546-6739
Mailing address
19718 W AMELIA AVE, BUCKEYE, AZ 85396-8300
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5404
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279672
—
AZ
Enumeration date
01/09/2014
Last updated
02/23/2022
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