Individual
TOMOHIRO IDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6001 DODGE ST SAPP FIELDHOUSE, OMAHA, NE 68182-0001
(531) 218-9130
Mailing address
6001 DODGE ST HEALTH AND KINESIOLOGY 207, OMAHA, NE 68182-0001
(531) 218-9130
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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