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1033708334
ETHAN MATTHEW PATE
LOUISA, KY
NPI
1033708334
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2021-01-12
Last Update Date
2021-01-12
Business Address
ETHAN MATTHEW PATE PSS
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-639-0938
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Mailing Address
ETHAN MATTHEW PATE PSS
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-639-0938
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