Individual
TATE COLYAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT/COTA
Contact information
Practice address
13811 N 35TH DR, PHOENIX, AZ 85053-5500
(623) 206-1826
Mailing address
13565 W BRILES RD, PEORIA, AZ 85383-8296
(623) 385-6692
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTA-006763
AZ
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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