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1083008940
KELLY ANDREW LARA
TUCSON, AZ
NPI
1083008940
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208600000X Surgery
(Licence: AZ 64112)
Additional Taxonomies
208600000X Surgery
(Licence: CA A148544)
Enumeration Date
2015-03-27
Last Update Date
2023-08-02
Business Address
KELLY ANDREW LARA
10120 E OLD VAIL RD STE 100
TUCSON, AZ 85747-9414
Phone number: 520-989-8012
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Mailing Address
KELLY ANDREW LARA
PO BOX 689022
FRANKLIN, TN 37068-9022
Phone number:
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