Individual
DAIKI TANIYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 S 4TH ST, LOUISVILLE, KY 40203-3205
(502) 686-0183
Mailing address
1511 BELLAMY PL UNIT 202C, LOUISVILLE, KY 40208-3706
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/24/2020
Last updated
02/24/2020
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