Doctor Name: | DR. LISA HOLLINGSWORTH UPSHAW |
NPI Number: | 1598938631 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.C., L. AC |
License Number: | 29832 |
Business Practice Address: | 614 Venice Blvd Venice, CA - 902914801 |
Business Phone Number: | 8777676217 |
Business Fax Number: | 8777676217 |
Mailing Address: | 318 Lincoln Blvd, Ste 225 VENICE |
State: | CA |
Postal Code: | 902912827 |
Phone Number: | 3103963635 |
Fax Number: | 8777676217 |
NPI Enumeration Date: | 04/09/2008 |
NPI Last Update Date: | 07/11/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 29832 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |