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1063129617
KENTA MIZUMOTO
LEXINGTON, KY
NPI
1063129617
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
Enumeration Date
2022-11-02
Last Update Date
2024-05-18
Business Address
KENTA MIZUMOTO
720 SPORTS CENTER DR
LEXINGTON, KY 40506-1298
Phone number: 859-539-4746
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Mailing Address
KENTA MIZUMOTO
720 SPORTS CENTER DR
LEXINGTON, KY 40506-0001
Phone number: 859-539-4746
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