Individual
VANZETTA PATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1205 35TH AVE W, BRADENTON, FL 34205-6237
(229) 449-3776
Mailing address
1205 35TH AVE W, BRADENTON, FL 34205-6237
(229) 449-3776
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061755364
DRIVER LICENSE
GA
Enumeration date
04/25/2022
Last updated
04/25/2022
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