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General NPI Number Information
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NPI Number | 1730888439
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Entity Type | Individual
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Provider Name | KARA CUELLAR PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 1665 N AVONDALE BLVD # 104
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City | AVONDALE
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State | AZ
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Zip | 85392-5006
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Country | US
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Telephone | 602-933-0980
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Fax |
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Provider Business Mailing Address
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Address Line | 5039 N 128TH DR
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-4112
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Country | US
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Telephone | 623-670-3664
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 32759
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License Number State | AZ
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