Individual
TATE R WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
18901 U ST, OMAHA, NE 68135-4101
(402) 992-0186
Mailing address
18901 U ST, OMAHA, NE 68135-4101
(402) 992-0186
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
774
NE
Other
Enumeration date
06/11/2013
Last updated
06/11/2013
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