Provider Demographics
NPI:1184787996
Name:FLORA, KANDRA (PT)
Entity type:Individual
Prefix:
First Name:KANDRA
Middle Name:
Last Name:FLORA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 W GUADALUPE RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-3003
Mailing Address - Country:US
Mailing Address - Phone:480-776-4565
Mailing Address - Fax:
Practice Address - Street 1:1410 W GUADALUPE RD
Practice Address - Street 2:SUITE 117
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-3003
Practice Address - Country:US
Practice Address - Phone:480-776-4565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6553225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist