Individual
MAKOTO TSUCHIYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1301 N COLUMBIA RD STOP 9037, GRAND FORKS, ND 58202-9037
(701) 777-0579
Mailing address
1301 N COLUMBIA RD STOP 9037, GRAND FORKS, ND 58202-9037
(701) 777-0579
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
141-95
ND
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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