MEDICARE: DR. KAZUMA AKEHI PH.D., ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1295142917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAZUMA AKEHI PH.D., ATC

Provider Business Mailing Address
First Line	:	1410 W 26TH ST
Second Line	:	CUSHING 129
City	:	KEARNEY
State	:	NE
Zip	:	68849-4902
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1410 W 26TH ST
Second Line	:	CUSHING 129
City	:	KEARNEY
State	:	NE
Zip	:	68849-4902
Country	:	US
Telephone Number	:	405-818-7153
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2014
Last Update Date	:	07/15/2014

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