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1063775823
CLIFTON TATE
SHREVEPORT, LA
NPI
1063775823
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: LA 273)
Enumeration Date
2012-06-18
Last Update Date
2012-06-18
Business Address
Mr. CLIFTON TATE RD
510 E STONER AVE
SHREVEPORT, LA 71101-4243
Phone number: 318-990-5030
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Mailing Address
Mr. CLIFTON TATE RD
510 E STONER AVE
SHREVEPORT, LA 71101-4243
Phone number: 318-990-5030
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