Individual
MR. JUSTIN TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
11701 BORMAN DR, SUITE 280, SAINT LOUIS, MO 63146-4100
(314) 983-9555
(314) 983-9444
Mailing address
2519 S 9TH ST, APT A, SAINT LOUIS, MO 63104-4710
Taxonomy
Speciality
Code
Description
License number
State
2279G1100X
General Care Registered Respiratory Therapist
Primary
2003017948
MO
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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