Individual
SUSAN DUKART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2300 PAVILION DR, KINGSPORT, TN 37660-4622
(423) 765-9655
Mailing address
2300 PAVILION DR, KINGSPORT, TN 37660-4622
(423) 765-9655
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2468
TN
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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