Kelly Mack, PTA

NPI #1972933646 in Maricopa, Arizona

Provider Information

NPI Number: 1972933646
Entity Type: Individual
Name: Kelly Mack, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Nov 17, 2013
Last Updated: Nov 17, 2013

Practice Location

Address: 44480 W HONEYCUTT RD
Address 2: #106
City: Maricopa
State: Arizona
ZIP Code: 85138-2903
Phone: (520) 582-0142

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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