Individual
ADDISON PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
845 SW 30TH ST, CORVALLIS, OR 97331-8629
(541) 768-7700
Mailing address
845 SW 30TH ST, CORVALLIS, OR 97331-8629
(541) 768-7700
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-10233073
OR
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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