KOUSAKU JESSE OHTAKE

LAWRENCE, KS
NPI1326883448
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: AZ  LPT-31859)
Enumeration Date2024-06-29
Last Update Date2024-06-29
Business Address
KOUSAKU JESSE OHTAKE
325 MAINE ST
LAWRENCE, KS 66044-1360
Phone number: 785-505-2712
Mailing Address
KOUSAKU JESSE OHTAKE
325 MAINE ST
LAWRENCE, KS 66044-1360
Phone number: 785-505-2712
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