Individual
SHIGERU TAKEUCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
ATHLETIC TRAINING DEPARTMENT, INDIANA STATE UNIVERSITY, TERRE HAUTE, IN 47809-0001
(812) 237-9613
Mailing address
201 CRAWFORD ST APT 317, TERRE HAUTE, IN 47807-4660
(812) 237-7423
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001300A
IN
Other
Enumeration date
08/30/2006
Last updated
07/21/2022
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