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Individual

GRANT A TATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
245 GOVERNORS DR SE, HUNTSVILLE, AL 35801-2700
(256) 265-8120
(256) 265-8969
Mailing address
PO BOX 1389, HUNTSVILLE, AL 35807-0389
(205) 979-5882
(205) 979-1248

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-117862
AL

Other

Enumeration date
02/12/2013
Last updated
02/12/2013
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