Individual
DAVID INOUYE TAKASAKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
331 SAB, PROVO, UT 84602
(801) 422-2096
Mailing address
355 N 500 W APT 102, PROVO, UT 84601-2601
(801) 388-2710
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
10890883-4810
UT
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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