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1326456849
TAKASHI MITA
FARGO, ND
NPI
1326456849
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2014-07-28
Last Update Date
2014-07-28
Business Address
Mr. TAKASHI MITA ATC
717 8TH ST N APT 9
FARGO, ND 58102-4470
Phone number: 308-293-7258
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Mailing Address
Mr. TAKASHI MITA ATC
717 8TH ST N APT 9
FARGO, ND 58102-4470
Phone number: 308-293-7258
Copy
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