Takeo Ichiyanagi, MS, ATC
NPI #1144637620 in Irmo, South Carolina
Provider Information
- NPI Number
- 1144637620
- Entity Type
- Individual
- Name
- Takeo Ichiyanagi, MS, ATC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- MS, ATC
- Enumeration Date
- Jul 17, 2014
- Last Updated
- Jul 17, 2014
Practice Location
- Address
- 6 YEARLING CT
- City
- Irmo
- State
- South Carolina
- ZIP Code
- 29063-2939
- Phone
- (803) 556-1089
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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