Individual
INGRID UPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
440 SAINT MICHAELS DR, SANTA FE, NM 87505-7602
(505) 913-5100
Mailing address
455 SAINT MICHAELS DR, PHYSICIAN PRACTICES, SANTA FE, NM 87505-7601
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
209
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10014145
LOVELACE
—
01
—
2413403
UHC
—
05
—
41983785
—
NM
01
—
8108494418
PHCS
—
01
—
NM00Q114
BCBS NM
NM
01
—
QMYPR0066896
MOLINA
—
Enumeration date
12/06/2006
Last updated
09/22/2010
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