Healthcare Provider Details

I. General information

NPI: 1851799761
Provider Name (Legal Business Name): CHIAKI HARA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHIAKI SATO

II. Dates (important events)

Enumeration Date: 12/09/2014
Last Update Date: 12/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2-29 KAMIUCHIMACHI
YOKOTE-SHI AKITA-KEN
0130014
JP

IV. Provider business mailing address

2-29 KAMIUCHIMACHI
YOKOTE-SHI AKITA-KEN
0130014
JP

V. Phone/Fax

Practice location:
  • Phone: 09072373925
  • Fax:
Mailing address:
  • Phone: 09072373925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: