Individual
MR. ICHIRO KITANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, ATC
Contact information
Practice address
651 N OLD COACHMAN RD, CLEARWATER, FL 33765-2321
(215) 341-7736
Mailing address
651 N OLD COACHMAN RD, CLEARWATER, FL 33765-2321
(215) 341-7736
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL1914
FL
Other
Enumeration date
11/27/2008
Last updated
11/27/2008
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