Individual
CODY SHIMOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
229 E 3RD ST, WINONA, MN 55987-6576
(612) 876-1615
Mailing address
229 E 3RD ST, WINONA, MN 55987-6576
(612) 876-1615
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/16/2017
Last updated
03/16/2017
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