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Contact Information

JENNIFER A UPHAM X, PTA
4216 BRIDLECREEK DR NW
ACWORTH, GA30101-3872
 Phone: 404-429-4012
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatrics

2251G0304X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for JENNIFER A UPHAM X · (Female)

NPI Number 1124407929
Status Active
Credentials PTA (Physical Therapist Assistant)
Entity Individual
Enumeration date 05/26/2015
Last updated 05/26/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # PTA0003392
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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