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Individual

MR. YASUO FUKUDA

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
A.T.C.

Contact information

Practice address
4201 S DECATUR BLVD, APT 2142, LAS VEGAS, NV 89103-5875
(702) 735-9425
Mailing address
4201 S DECATUR BLVD, APT 2142, LAS VEGAS, NV 89103-5875
(702) 735-9425

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0506024
NV

Other

Enumeration date
05/01/2006
Last updated
07/08/2007
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