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Individual

KIRSTEN M UPTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1975 MIAMISBURG CENTERVILLE RD, CENTERVILLE, OH 45459-3811
(937) 439-6186
(937) 723-2638
Mailing address
1975 MIAMISBURG CENTERVILLE RD, CENTERVILLE, OH 45459-3811
(937) 439-6186
(937) 723-2638

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004881RX
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
50.004881RX
LICENSE
OH
Enumeration date
11/16/2016
Last updated
10/30/2024
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