Individual
SATOSHI IIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 S DUNN AVE., APT 205A, FAYETTEVILLE, AR 72701
(650) 391-6377
Mailing address
1010 S DUNN AVE., APT 205A, FAYETTEVILLE, AR 72701
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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