Individual
COREY J YATES
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
685 36TH AVE NE, SALEM, OR 97301-4741
(503) 371-8860
Mailing address
3736 SARAMAE LN NE, KEIZER, OR 97303-4054
(503) 371-8860
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT AT 621435
OR
Other
Enumeration date
04/07/2006
Last updated
07/08/2007
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