Individual
MRS. TIERRA S RIVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2702 W SURREY DR, NORTH CHARLESTON, SC 29405-5513
(843) 817-6803
Mailing address
2702 W SURREY DR, NORTH CHARLESTON, SC 29405-5513
(843) 817-6803
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
76417
SC
Other
Enumeration date
07/27/2020
Last updated
12/26/2024
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