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Individual

KOICHIRO NAKANISHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
1792 ALYSHEBA WAY STE 140, LEXINGTON, KY 40509-2289
(859) 264-9249
Mailing address
1792 ALYSHEBA WAY STE 140, LEXINGTON, KY 40509-2289
(859) 264-9249

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
008964
KY
225700000X
Massage Therapist
148448
KY

Other

Enumeration date
10/04/2021
Last updated
11/21/2023
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