Individual
MS. ALMA RAE MATTOCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2043 COLLEGE WAY, FOREST GROVE, OR 97116-1756
(503) 352-2780
Mailing address
NORTHERN KENTUCKY UNIVERSITY, NUNN DRIVE / HC 116, HIGHLAND HEIGHTS, KY 41099
(503) 880-0457
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-1005014
OR
Other
Enumeration date
02/11/2007
Last updated
01/10/2019
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