Individual
BENJAMIN TATE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
100 W COLLEGE ST, GRANVILLE, OH 43023-1100
(740) 587-5063
Mailing address
126 ANDOVER RD APT C, HEATH, OH 43056-1394
(814) 823-2482
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AT004792
OH
Other
Enumeration date
07/04/2020
Last updated
07/04/2020
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