Provider Demographics
NPI:1376144378
Name:UPER, INC
Entity type:Organization
Organization Name:UPER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:G
Authorized Official - Last Name:CLYMER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:906-484-2330
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:HESSEL
Mailing Address - State:MI
Mailing Address - Zip Code:49745-0069
Mailing Address - Country:US
Mailing Address - Phone:906-484-2330
Mailing Address - Fax:
Practice Address - Street 1:3197 E ROCKY TRL
Practice Address - Street 2:
Practice Address - City:CEDARVILLE
Practice Address - State:MI
Practice Address - Zip Code:49719-9560
Practice Address - Country:US
Practice Address - Phone:906-484-2330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty