Individual
KENTA MIYAZAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
101 BROAD STREET, SUNY PLATTSBURGH,, PLATTSBURGH, NY 12901
(518) 564-3089
Mailing address
101 BROAD STREET, SUNY PLATTSBURGH,, PLATTSBURGH, NY 12901
(518) 564-3089
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002627-1
NY
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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