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Individual

DR. DANIEL LAWRENCE UPTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
415 N. BROADWAY AVE., SUITE 2, RED LODGE, MT 59068-1637
(406) 446-4433
(406) 446-4433
Mailing address
415 N. BROADWAY AVE., SUITE 2, RED LODGE, MT 59068-1637
(406) 446-4433
(406) 446-4433

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
961
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
61-1423592
FEDERAL TAX ID
MT
Enumeration date
11/02/2006
Last updated
09/29/2011
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