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Organization
UPPER VALLEY PROFESSIONAL CORPORATION
Active
Organization
UPPER VALLEY PROFESSIONAL CORPORATION
Active
Other names
Internal Medicine Group
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA RADER (ADMINISTRATOR)
(937) 440-7454
Entity
Organization
Contact information
Practice address
31 S STANFIELD RD, SUITE 301, TROY, OH 45373-2374
(937) 339-3085
(937) 335-5865
Mailing address
PO BOX 479, TROY, OH 45373-0479
(937) 339-3085
(937) 335-5865
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2616404
—
OH
Enumeration date
09/22/2006
Last updated
08/20/2010
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