Individual
BRANDI TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3148 HIGHWAY 367 S, CABOT, AR 72023-7473
(501) 941-3500
Mailing address
3127 SOUTHWEST DR, JONESBORO, AR 72404-8404
(870) 336-8100
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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