Individual
LAURA ALEXANDRIA UPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1225 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 977-6100
Mailing address
2255 WISCONSIN AVE NW APT 417, WASHINGTON, DC 20007-4165
(321) 604-0034
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
TBD
MO
207R00000X
Internal Medicine Physician
TBD
MO
Other
Enumeration date
03/26/2021
Last updated
03/26/2021
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