Individual
KEYUANA TIERA RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6990 BOXBOROUGH CV, MEMPHIS, TN 38119-8783
(901) 562-6476
(855) 232-8604
Mailing address
6990 BOXBOROUGH CV, MEMPHIS, TN 38119-8783
(901) 562-6476
(855) 232-8604
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2621
TN
Other
Enumeration date
02/11/2019
Last updated
02/12/2019
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