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General NPI Number Information
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NPI Number | 1770275604
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Entity Type | Organization
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Legal Business Name | UPTON WELLNESS LLC
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 833 GRANDVIEW AVE
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City | COLUMBUS
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State | OH
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Zip | 43215-1123
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Country | US
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Telephone | 614-524-4986
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Fax |
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Provider Business Mailing Address
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Address Line | 901 YARD ST
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City | COLUMBUS
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State | OH
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Zip | 43212-3907
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Country | US
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Telephone | 513-659-0862
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | DR. COLE UPTON
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Credential | DNP, PMHNP
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Telephone | 513-659-0862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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