Individual
MANDY JAMELIA TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(800) 711-5444
Mailing address
6 GREENBRANCH WAY, SIMPSONVILLE, SC 29680-7634
(864) 421-2489
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/18/2022
Last updated
04/18/2022
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