Individual
HOLLY ELIZABETH TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1200 SW 104TH ST, OKLAHOMA CITY, OK 73139-3019
(405) 759-3773
Mailing address
PO BOX 128, UNION CITY, OK 73090-0128
(405) 613-7721
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2022
OK
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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