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1386186039
KIMBALL TATE
BASTROP, LA
NPI
1386186039
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2016-11-12
Last Update Date
2016-11-12
Business Address
-- KIMBALL TATE
209 W JEFFERSON AVE
BASTROP, LA 71220-4543
Phone number: 318-239-3890
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Mailing Address
-- KIMBALL TATE
209 W JEFFERSON AVE
BASTROP, LA 71220-4543
Phone number: 318-239-3890
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