Healthcare Provider Details

I. General information

NPI: 1205120169
Provider Name (Legal Business Name): YUKO KIMURA ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YUKO KIMURA

II. Dates (important events)

Enumeration Date: 06/07/2011
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 MUNDIS MILL RD
YORK PA
17406-9714
US

IV. Provider business mailing address

601 MUNDIS MILL RD
YORK PA
17406-9714
US

V. Phone/Fax

Practice location:
  • Phone: 717-846-6789
  • Fax:
Mailing address:
  • Phone: 717-846-6789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT006651
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: