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Individual

MRS. ALICIA TATE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8455 HIGHWAY 85 STE A3, RIVERDALE, GA 30274-5115
(708) 881-0744
Mailing address
5949 FAIRINGTON RD, LITHONIA, GA 30038-1706
(470) 274-6166

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary

Other

Enumeration date
02/08/2019
Last updated
02/08/2019
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