Individual
BLAKE THOMAS UPHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1518 SUNSET DR, SENECA, KS 66538-2125
(785) 294-8514
Mailing address
1518 SUNSET DR, SENECA, KS 66538-2125
(785) 294-8514
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/20/2019
Last updated
09/20/2019
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