Individual
MR. TATE STEPHEN ERICKSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
580 COURT ST, KEENE, NH 03431-1715
(603) 354-5454
Mailing address
573 WEST ST, KEENE, NH 03431-2809
(603) 903-0047
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
298
NH
Other
Enumeration date
10/31/2005
Last updated
07/08/2007
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