Individual provider · NPI-1

Mindy S Depue, ATC

Specialist/Technologist, Athletic Trainer · Corvallis, OR

NPI number1083744593
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1083744593
Entity type
Individual (NPI-1)
Name
Mindy S Depue
Credential
ATC
Sex
Female
Sole proprietor
No
Enumeration date
Mar 6, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainerat-at-1007419ORYes

Practice location

4444 Nw Highland Dr
Corvallis, OR 97330-9734

Phone 541-766-4909

Mailing address

2491 Waterford St Se
Albany, OR 97322-8818

Phone 541-990-2388

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