Individual
MS. STEPHANIE UPHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3710 CHAMBERLAIN LN STE A, LOUISVILLE, KY 40241-2002
(502) 995-4004
(502) 933-5559
Mailing address
PO BOX 24261, LOUISVILLE, KY 40224-0261
(502) 995-4004
(502) 933-5559
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
KY36217
KY
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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