Individual
TAIJIRO KOYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
200 RICHLAND AVE, ATHENS, OH 45701
(585) 815-5344
Mailing address
9327 STATE ROUTE 682 APT 214, ATHENS, OH 45701
(585) 815-5344
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT007039
OH
Other
Enumeration date
08/14/2024
Last updated
08/14/2024
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