Individual
ITSUKO YAMAGUCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., ATC, LAT
Contact information
Practice address
640 DR MARY MCLEOD BETHUNE BLVD, DAYTONA BEACH, FL 32114-3012
(386) 481-2281
Mailing address
640 DR MARY MCLEOD BETHUNE BLVD, DAYTONA BEACH, FL 32114-3012
(386) 481-2281
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL4062
FL
Other
Enumeration date
02/03/2015
Last updated
02/03/2015
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