Individual
LESTER TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 S JT STITES, SALLISAW, OK 74955
(918) 775-7787
Mailing address
205 S JT STITES, SALLISAW, OK 74955
(918) 775-7787
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/25/2012
Last updated
01/25/2012
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