| Provider / Organization | NPI | Date Certified |
|---|---|---|
| BENJAMIN TATE | 1477170603 | 2020-07-04 |
Benjamin Tate is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1477170603. Registration indicates Benjamin Tate is a provider of services with a specialization in Allopathic & Osteopathic Physicians, Physical Medicine & Rehabilitation (Physical Medicine & Rehabilitation: Sports Medicine, ) (Specialist Network, ) (Physical Medicine & Rehabilitation Sports Medicine, Allopathic & Osteopathic Physicians) (Physical Medicine & Rehabilitation, )
| Entity Type | Individual |
| Provider Name | Benjamin Tate Jr. MS, ATC |
| Practice Office Address | 100 W COLLEGE ST GRANVILLE, OH US |
| Practice Office Telephone | 7405875063 |
| Mailing Address | 126 ANDOVER RD APT C HEATH, OH 430561394 US |
| Business Telephone | 8148232482 |
| Code | Practice | License No State |
|---|---|---|
| 2081S0010X PRIMARY | Allopathic & Osteopathic Physicians Physical Medicine & Rehabilitation Physical Medicine & Rehabilitation: Sports Medicine Specialist Network Physical Medicine & Rehabilitation Sports Medicine Allopathic & Osteopathic Physicians Physical Medicine & Rehabilitation | AT004792
OH |