Individual
TAKUYA TOYAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1815 WELLS ST, LAS CRUCES, NM 88003-8001
(336) 256-1455
Mailing address
3901 SONOMA SPRINGS AVE, APT 1116, LAS CRUCES, NM 88011
(415) 872-2455
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-2023-0007
NM
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/12/2019
Last updated
01/18/2024
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