Individual
HILARY ISHII
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC,LAT
Contact information
Practice address
1500 S AVE K STATION 17, PORTALES, NM 88130
(575) 562-4176
Mailing address
126 N AVE E #3, PORTALES, NM 88130
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
558
NM
Other
Enumeration date
12/15/2014
Last updated
12/15/2014
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