Provider Demographics
NPI:1669958807
Name:UPRIGHT, RYAN CHANDLER (COTA/L)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:CHANDLER
Last Name:UPRIGHT
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1243
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28082-1243
Mailing Address - Country:US
Mailing Address - Phone:704-796-0155
Mailing Address - Fax:
Practice Address - Street 1:1404 S SALISBURY AVE
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:NC
Practice Address - Zip Code:28159-1921
Practice Address - Country:US
Practice Address - Phone:704-633-3892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11884224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant