Individual
MINDY S DEPUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4444 NW HIGHLAND DR, CORVALLIS, OR 97330-9734
(541) 766-4909
Mailing address
2491 WATERFORD ST SE, ALBANY, OR 97322-8818
(541) 990-2388
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-1007419
OR
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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