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Individual

MR. JEREMIAH J TATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
105 MEADOW VIEW RD, SUITE 4, BRISTOL, TN 37620-1725
(423) 844-6935
(423) 844-6937
Mailing address
105 MEADOW VIEW RD, SUITE 4, BRISTOL, TN 37620-1725
(423) 844-6935
(423) 844-6937

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5994
TN
2251X0800X
Orthopedic Physical Therapist
PT0000005994
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103I652884
TN
05
1517092
TN
Enumeration date
09/29/2009
Last updated
07/17/2025
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