KELLY ANDREW LARA

TUCSON, AZ
NPI1083008940
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy208600000X Surgery
(Licence: AZ  64112)
Additional Taxonomies208600000X Surgery
(Licence: CA  A148544)
Enumeration Date2015-03-27
Last Update Date2025-08-23
Business Address
KELLY ANDREW LARA
2300 S HOUGHTON RD STE 160
TUCSON, AZ 85748-0046
Phone number: 520-352-1083
Mailing Address
KELLY ANDREW LARA
PO BOX 689022
FRANKLIN, TN 37068-9022
Phone number: