Individual
MARY UPTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1030 RIVER OAKS DR, FLOWOOD, MS 39232-9553
(601) 936-1392
Mailing address
2222 WILD VALLEY DR, JACKSON, MS 39211-6164
(601) 936-1392
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1469
MS
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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