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Individual

PHILLIP UPHAM V

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2040 W MAIN ST, STE 210-2422, RAPID CITY, SD 57702-0904
(505) 832-5817
(505) 832-5918
Mailing address
2040 W MAIN ST,, SUITE 210-2422, RAPID CITY, SD 57702-2570
(505) 832-5918
(505) 832-5918

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I-1756
NM

Other

Enumeration date
04/26/2007
Last updated
03/08/2010
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