Individual
MR. IVAN PATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2405 OSLER CT, SUITE 200, ALBANY, GA 31707-0214
(229) 883-4009
(229) 883-4320
Mailing address
156 WINDING WAY APT C, LEESBURG, GA 31763-5055
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002360
GA
Other
Enumeration date
03/21/2013
Last updated
03/21/2013
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