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Individual

VIOLET D TATE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT, LPN

Contact information

Practice address
83370 HIGHWAY 25, FOLSOM, LA 70437
(985) 796-3364
(985) 796-9116
Mailing address
PO BOX 1612, FOLSOM, LA 70437-1612
(985) 796-3364
(985) 796-9116

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LA1498-01
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1669531372
LA
Enumeration date
04/11/2008
Last updated
04/11/2008
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