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Individual

MADISON A TATE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
8120 GARNET DR, DAYTON, OH 45458-2141
(513) 834-7063
Mailing address
615 ELSINORE PL STE 200, CINCINNATI, OH 45202-1457
(513) 834-7063

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006240RX
OH

Other

Enumeration date
09/17/2019
Last updated
07/27/2021
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