Provider Demographics
NPI:1497053466
Name:UPSHAW, BRITTANY D
Entity Type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:D
Last Name:UPSHAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 BUFFALO PL
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32348-5137
Mailing Address - Country:US
Mailing Address - Phone:850-223-1515
Mailing Address - Fax:850-223-1515
Practice Address - Street 1:112 BUFFALO PL
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32348-5137
Practice Address - Country:US
Practice Address - Phone:850-223-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath