Individual
YUYA MUKAIHARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
3900 E RAAB RD, NORMAL, IL 61761-9487
(541) 602-9050
Mailing address
403 GREENBRIAR DR APT 214, NORMAL, IL 61761-6221
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003468
IL
Other
Enumeration date
02/26/2014
Last updated
02/26/2014
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