| NPI | 1760834154 | 
|---|---|
| Other Name | KELLY COLLEEN FARRELL | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-012573) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 0014057) | 
| Enumeration Date | 2016-07-08 | 
| Last Update Date | 2022-02-12 |