Organization
1632 E COTTONWOOD ST UNITS A & B LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAINE UPHAM DC (MEMBER)
(928) 399-9469
Entity
Organization
Contact information
Practice address
1632 E COTTONWOOD ST STE A, COTTONWOOD, AZ 86326-4692
(928) 646-9220
Mailing address
1632 E COTTONWOOD ST STE A, COTTONWOOD, AZ 86326-4692
(928) 646-9220
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
10/10/2025
Last updated
10/10/2025
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