Individual
ROBERT ROOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1128 NE 2ND ST, SUITE 201, CORVALLIS, OR 97330-6230
(541) 757-8100
(541) 754-2707
Mailing address
1128 NE 2ND ST, SUITE 201, CORVALLIS, OR 97330-6230
(541) 757-8100
(541) 754-2707
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-10151745
OR
Other
Enumeration date
04/18/2014
Last updated
04/18/2014
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