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1316330178
KELLY MARTIN
GLENDALE, AZ
NPI
1316330178
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225400000X Rehabilitation Practitioner
(Licence: AZ 5909)
Enumeration Date
2015-03-17
Last Update Date
2015-03-17
Business Address
-- KELLY MARTIN COTA
12111 N 66TH AVE
GLENDALE, AZ 85304-1625
Phone number: 573-569-0144
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Mailing Address
-- KELLY MARTIN COTA
12111 N 66TH AVE
GLENDALE, AZ 85304-1625
Phone number: 573-569-0144
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