Individual
KELLY MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6351 S DESERT BLVD BLDG C, EL PASO, TX 79932-1219
(915) 245-3131
Mailing address
6351 S DESERT BLVD BLDG C, EL PASO, TX 79932-1219
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2132355
TX
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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