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JASON PATE

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1770905077

Individual Registrant:
 JASON  PATE 
Gender: M
Sole Proprietor

Location and contact information for practice:
234 GEORGIA ST  IMBODEN, AR 72434-9304 US
Tel: 731-335-2317  Fax: --

Contact information for business:
234 GEORGIA ST  IMBODEN, AR 72434-9304 US
Tel: 731-335-2317  Fax: --

Registration Information:
NPI: 1770905077
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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