Individual
RACHEL TIERNEY PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 E STONE AVE, GREENVILLE, SC 29609-5619
(864) 522-6550
Mailing address
109 W CIRCLE AVE, GREENVILLE, SC 29607-1516
(317) 354-7903
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006890RX
OH
Other
Enumeration date
03/01/2021
Last updated
06/07/2024
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