| NPI | 1003816653 |
|---|---|
| Former Name | KATIE LYNN MATSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT 002289) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2010-12-23 |