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Individual

MACI TATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3080 W 3RD ST, ELK CITY, OK 73644-4323
(405) 424-7711
Mailing address
1701 CORBIN LN, WEATHERFORD, OK 73096-6114

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
218759
OK

Other

Enumeration date
07/10/2024
Last updated
07/10/2024
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