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1053467555
MASAYASU TAKAIWA
YPSILANTI, MI
NPI
1053467555
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2007-01-26
Last Update Date
2007-07-08
Business Address
Mr. MASAYASU TAKAIWA MA, ATC
799 N HEWITT RD 142 CONVOCATION CENTER
YPSILANTI, MI 48197-1701
Phone number: 734-487-5179
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Mailing Address
Mr. MASAYASU TAKAIWA MA, ATC
31245 WELLINGTON DR APT 23301
NOVI, MI 48377-4236
Phone number: 734-395-7540
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