Provider Demographics
NPI:1376921932
Name:UPLEDGER INSTITUTE CLINIC
Entity Type:Organization
Organization Name:UPLEDGER INSTITUTE CLINIC
Other - Org Name:INTERNATIONAL ALLIANCE OF HEALTHCARE EDUCATORS INC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:UPLEDGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-622-4706
Mailing Address - Street 1:11211 PROSPERITY FARMS RD
Mailing Address - Street 2:SUITE D223
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3487
Mailing Address - Country:US
Mailing Address - Phone:561-622-4706
Mailing Address - Fax:561-627-9231
Practice Address - Street 1:11211 PROSPERITY FARMS RD
Practice Address - Street 2:SUITE D223
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3487
Practice Address - Country:US
Practice Address - Phone:561-622-4706
Practice Address - Fax:561-627-9231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty