Individual
JUDE UPCHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
3905 UNIVERSITY DR, DURHAM, NC 27707-2517
(919) 928-0204
Mailing address
1107 NEW DOVER RD, APEX, NC 27502-7130
(919) 641-6393
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
15658
NC
Other
Enumeration date
05/03/2023
Last updated
07/13/2023
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