Individual
THERESA TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3930 SUNFOREST CT STE 100, TOLEDO, OH 43623-4441
(419) 251-8760
Mailing address
10300 S BRAMBLEWOOD RD, PERRYSBURG, OH 43551-3630
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
4034
OH
Other
Enumeration date
02/21/2014
Last updated
02/21/2014
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