Jennifer Anne Upham X
Physical Therapist - Geriatrics
4216 Bridlecreek Dr Nw
Acworth
, Georgia 30101-3872
Jennifer Anne Upham X
Physical Therapist - Geriatrics
4216 Bridlecreek Dr Nw
Acworth
, Georgia 30101-3872
(404) 429-4012
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About
Features
Specialties
- Physical Therapist - Geriatrics
Languages spoken
- English
Location
First Address
- Jennifer Anne Upham X
- 4216 Bridlecreek Dr Nw
- Acworth, GA
- Zip : 30101-3872
- Phone : (404) 429-4012
Second Address
- Jennifer Anne Upham X
- 4216 Bridlecreek Dr Nw
- Acworth, GA
- Zip : 30101-3872
- Phone : (404) 429-4012
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251G0304X | Physical Therapist - Geriatrics | PTA0003392 | GA |
National Provider Identifier
| NPI | 1124407929 |
|---|---|
| Provider Name | Jennifer Anne Upham X |
| First Address | Acworth, GA 30101-3872 |
| Second Address | Acworth, GA 30101-3872 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/05/2015 |
| Last Update Date | 26/05/2015 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.