Individual
DAVID TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 CEDAR TREE DR, THIBODAUX, LA 70301-5724
(985) 438-7770
Mailing address
200 CEDAR TREE DR, THIBODAUX, LA 70301-5724
Taxonomy
Speciality
Code
Description
License number
State
171WV0202X
Vehicle Modifications Contractor
Primary
—
—
Other
Enumeration date
08/31/2015
Last updated
09/01/2015
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