Blaine Upham DC PC

NPI #1598179210 in Wasilla, Alaska

Provider Information

NPI Number: 1598179210
Entity Type: Organization
Organization Name: Blaine Upham DC PC
Primary Specialty: Chiropractor
Enumeration Date: Jun 20, 2014
Last Updated: Jun 20, 2014

Practice Location

Address: 5461 E MAYFLOWER LN
Address 2: SUITE # 6
City: Wasilla
State: Alaska
ZIP Code: 99654-7892
Phone: (907) 357-6688

Authorized Official

Name: BLAINE UPHAM, DC
Title: PRESIDENT
Phone: (907) 357-6688

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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