TAKAO IWANO

THOMASVILLE, GA
NPI1497108401
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: SC  1956)
Enumeration Date2016-07-14
Last Update Date2018-12-28
Business Address
TAKAO IWANO
1550 MAGNOLIA ST
THOMASVILLE, GA 31792-7236
Phone number: 660-864-6124
Mailing Address
TAKAO IWANO
1550 MAGNOLIA ST
THOMASVILLE, GA 31792-7236
Phone number: 660-864-6124
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