Individual
MR. IKURI OGATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1532 W CLYBOURN ST, MILWAUKEE, WI 53233-2202
(414) 248-3060
Mailing address
1532 W CLYBOURN ST, MILWAUKEE, WI 53233-2202
(414) 248-3060
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1753
WI
Other
Enumeration date
09/06/2017
Last updated
07/21/2022
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