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General NPI Number Information
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NPI Number | 1265295752
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Entity Type | Individual
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Provider Name | YUKA OGATA ATC/L
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Gender | Female
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Dates
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Enumeration Date | 02/06/2024
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 2601 S WOOD BLVD
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City | GOODYEAR
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State | AZ
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Zip | 85338-6914
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Country | US
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Telephone | 216-218-3851
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Fax |
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Provider Business Mailing Address
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Address Line | 313 E JEFFERSON ST APT A11
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City | MEDIA
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State | PA
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Zip | 19063-3843
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Country | US
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Telephone | 216-218-3851
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT006847
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License Number State | OH
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