Individual
MR. CLIFTON TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 990-5030
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 990-5030
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
273
LA
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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