Healthcare Provider Details

I. General information

NPI: 1114986544
Provider Name (Legal Business Name): CAROLYN MARIE SELBY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7532 N LA CHOLLA BLVD
TUCSON AZ
85741-2307
US

IV. Provider business mailing address

7532 N LA CHOLLA BLVD
TUCSON AZ
85741-2307
US

V. Phone/Fax

Practice location:
  • Phone: 520-748-6076
  • Fax:
Mailing address:
  • Phone: 520-748-6076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberLPT-30916
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: