Individual
BRIAN UPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10425 SOARING EAGLE DR, RIVERVIEW, FL 33578-3354
(813) 236-1947
Mailing address
1158 CHELSEA LN, HOLIDAY, FL 34691-5128
(813) 787-2998
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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