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General NPI Number Information
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NPI Number | 1679310296
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Entity Type | Individual
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Provider Name | MARISA UPTMOR DPT
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Gender | Female
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Dates
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Enumeration Date | 07/10/2024
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 2400 DEL PASO RD STE 132
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City | SACRAMENTO
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State | CA
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Zip | 95834-9629
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Country | US
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Telephone | 916-886-2940
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Fax |
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Provider Business Mailing Address
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Address Line | 6075 SW 27TH ST
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City | MIAMI
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State | FL
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Zip | 33155-3175
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Country | US
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Telephone | 786-201-0445
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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