Individual
INNA TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
13770 W BELL RD, SURPRISE, AZ 85374-3865
(623) 544-2255
Mailing address
13770 W BELL RD, SURPRISE, AZ 85374-3865
(623) 544-2255
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO-002490
AZ
Other
Enumeration date
04/04/2025
Last updated
04/04/2025
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