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General NPI Number Information
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NPI Number | 1801606736
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Entity Type | Individual
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Provider Name | JOHN BARRETT UPTON III D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 7950 DANI DR STE 310
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City | FORT MYERS
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State | FL
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Zip | 33966-8012
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Country | US
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Telephone | 239-936-5545
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Fax |
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Provider Business Mailing Address
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Address Line | 4727 MIRAGE BAY CIR UNIT 1302
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City | FORT MYERS
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State | FL
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Zip | 33966-6621
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Country | US
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Telephone |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 15310
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License Number State | FL
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