Individual
TOMOMI NISHIHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1320 10TH AVE S, MOORHEAD, MN 56560-3771
(612) 295-8629
Mailing address
1320 10TH AVE S, MOORHEAD, MN 56560-3771
(612) 295-8629
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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