Individual
MAYBELLE CODY UPSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
167 N. MAIN ST., TUBA CITY, AZ 86045
(928) 283-2559
Mailing address
PO BOX 1423, TUBA CITY, AZ 86045
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA999952714
AZ
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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