Individual
KIYOMASA KOMATSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
210 LINDSEY WILSON ST, COLUMBIA, KY 42728-1223
(270) 634-2519
Mailing address
210 LINDSEY WILSON ST, COLUMBIA, KY 42728-1223
(270) 634-2519
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000031780
KY
Other
Enumeration date
09/03/2018
Last updated
09/03/2018
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