Individual
KATIE GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
453 W 10TH AVE, COLUMBUS, OH 43210-2205
(614) 292-1706
Mailing address
913 BUCCANEER DR APT D, GLENVIEW, IL 60026-7050
(847) 220-3639
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XOF839898356
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/21/2020
Last updated
08/21/2020
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