KOKI IKEDA

MACON, GA
NPI1437822715
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date2021-08-01
Last Update Date2021-08-01
Business Address
KOKI IKEDA ATC
1501 MERCER UNIVERSITY DR
MACON, GA 31207-1515
Phone number: 209-355-7806
Mailing Address
KOKI IKEDA ATC
296 ORANGE ST APT 5
MACON, GA 31201-1688
Phone number: 209-355-7806
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