Individual
MR. MASAYASU TAKAIWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, ATC
Contact information
Practice address
799 N HEWITT RD, 142 CONVOCATION CENTER, YPSILANTI, MI 48197-1701
(734) 487-5179
(734) 487-5173
Mailing address
31245 WELLINGTON DR APT 23301, NOVI, MI 48377-4236
(734) 395-7540
(734) 487-5173
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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