Individual
MASAHIRO TAKAHAGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1001 DIAMOND ST, PHILADELPHIA, PA 19122-1204
(215) 204-0873
Mailing address
1001 DIAMOND ST, PHILADELPHIA, PA 19122-1204
(215) 204-0873
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT005374
PA
Other
Enumeration date
08/14/2012
Last updated
10/19/2012
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