Individual
KATIE HOMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, ATC
Contact information
Practice address
114 GILL COLISEUM, CORVALLIS, OR 97331-8547
(541) 257-7252
Mailing address
114 GILL COLISEUM, CORVALLIS, OR 97331-8547
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-10164775
OR
Other
Enumeration date
03/26/2018
Last updated
03/26/2018
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