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Individual

CARMELITA UPSHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
CORNER OF ROUTE N12/N7, FORT DEFIANCE, AZ 86504-0649
(928) 729-3776
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(928) 729-3776

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8458
AZ

Other

Enumeration date
09/29/2009
Last updated
09/29/2009
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