Individual
KENJI UEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
2300 MACCORKLE AVE SE, CHARLESTON, WV 25304-1045
(304) 840-9185
Mailing address
2300 MACCORKLE AVE SE, CHARLESTON, WV 25304-1045
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001295
WV
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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