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Individual

MATEA MICHELLE DEPOE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S, LAT, ATC

Contact information

Practice address
2360 MULLAN RD, SUITE D, MISSOULA, MT 59808-1811
(406) 542-4702
Mailing address
2200 GREAT NORTHERN AVE, APT B16, MISSOULA, MT 59808-1605
(406) 207-9149

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATR-LAT-LIC-1470
MT

Other

Enumeration date
12/01/2016
Last updated
12/01/2016
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