Carmelita Upshaw, | |
Corner Of Route N12/n7, Fort Defiance, AZ 86504-0649 | |
(928) 729-3776 | |
Not Available |
Full Name | Carmelita Upshaw |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | Corner Of Route N12/n7, Fort Defiance, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558695130 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 8458 (Arizona) | Primary |
Provider Name | The Fort Defiance Indian Hospital Board, Incorporation |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1477876639 PECOS PAC ID: 0941336697 Enrollment ID: O20100429001153 |
Mailing Address | Practice Location Address |
---|---|
Carmelita Upshaw, Po Box 649, Fort Defiance, AZ 86504-0649 Ph: (928) 729-3776 | Carmelita Upshaw, Corner Of Route N12/n7, Fort Defiance, AZ 86504-0649 Ph: (928) 729-3776 |
Sarah Maria Berkenstock, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: N7, Corner Of Routes N12, Fort Defiance, AZ 86504 Phone: 928-729-8000 | |
Robbie Whitehair, MPT Physical Therapist Medicare: Medicare Enrolled Practice Location: Corner Of Route N12 And N7, Fort Defiance Indian Hospital Board, Inc., Fort Defiance, AZ 86504 Phone: 928-729-8810 | |
Dr. Jonathan Thomas Keown, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8000 | |
Miss Deidrea Rose Salabye, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8000 Fax: 928-729-8814 | |
Ms. Alana Marie Bencivengo, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: Corner Of Route 12 And 7, Fort Defiance, AZ 86504 Phone: 928-729-8000 | |
Mrs. Kathryn Elizabeth Jacques, MPT Physical Therapist Medicare: Medicare Enrolled Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8132 | |
Dr. Craig Amidon Fox, DPT, NCS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8810 |