Individual
KEISUKE KAWATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, ATC
Contact information
Practice address
1025 E 7TH ST # C215, BLOOMINGTON, IN 47405-7109
(812) 855-5244
Mailing address
1025 E 7TH ST # C215, BLOOMINGTON, IN 47405-7109
(812) 855-5244
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002932A
IN
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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