Individual
MR. GERALD T TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4835 N CHERRYVALE AVE, APPLETON, WI 54913-9383
(920) 427-0350
Mailing address
4835 N CHERRYVALE AVE, APPLETON, WI 54913-9383
(920) 427-0350
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9723
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40386500
—
WI
Enumeration date
08/12/2005
Last updated
12/23/2020
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