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General NPI Number Information
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NPI Number | 1588377782
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Entity Type | Organization
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Legal Business Name | AMBER UPCHURCH, LLC
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Dates
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Enumeration Date | 01/03/2023
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Last Update Date | 01/03/2023
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Provider Practice Location Address
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Address Line | 6200 RAMSEY ST STE 150
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-9314
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Country | US
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Telephone | 910-822-7722
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Fax |
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Provider Business Mailing Address
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Address Line | 224 DIAMOND POINT TRL
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-8833
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Country | US
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Telephone | 910-964-6581
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Fax |
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Authorized Official
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Title or Position | OWNER OF COMPANY
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Name | AMBER UPCHURCH
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Credential |
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Telephone | 910-964-6581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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