Individual
ISSEI MIYAGUCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2201 MOIX BLVD APT 615, CONWAY, AR 72034-6975
(501) 269-9614
Mailing address
2201 MOIX BLVD APT. 615, CONWAY, AR 72034
(501) 269-9614
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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