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Individual

CAITLIN NICOLE ALLISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
200 I ST NE, ATTN: ATHLETIC TRAINING, MIAMI, OK 74354
(918) 594-6323
Mailing address
200 I ST NE, ATTN: ATHLETIC TRAINING, MIAMI, OK 74354

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2015003670
MO
2255A2300X
Athletic Trainer
Primary
843
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2000017483
BOARD OF CERTIFICATION FOR THE ATHLETIC TRAINER
01
2015003670
MISSOURI DIVISION OF PROFESSIONAL REGISTRATION, ATHLETIC TRAINER LICENSE
MO
01
843
OKLAHOMA MEDICAL BOARD, ATHLETIC TRAINER LICENSE
OK
Enumeration date
12/30/2017
Last updated
12/30/2017
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