Individual
TAMAMI IIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 E 14TH ST, ADA, OK 74820-6915
(580) 332-8000
Mailing address
1100 E 14TH ST, ADA, OK 74820-6915
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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