Provider Demographics
NPI:1881871457
Name:YANAGI, KAZUHIKO (ATC, LAT)
Entity type:Individual
Prefix:
First Name:KAZUHIKO
Middle Name:
Last Name:YANAGI
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 E UNIVERSITY BLVD
Mailing Address - Street 2:UTPB DEPARTMENT OF ATHLETICS
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-8122
Mailing Address - Country:US
Mailing Address - Phone:432-552-2679
Mailing Address - Fax:
Practice Address - Street 1:4901 E UNIVERSITY BLVD
Practice Address - Street 2:UTPB DEPARTMENT OF ATHLETICS
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-8122
Practice Address - Country:US
Practice Address - Phone:432-552-2679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-26
Last Update Date:2008-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT39432255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer