Individual
TAMMY PROCKIW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1031 CHUCK DAWLEY BLVD STE 3, MT PLEASANT, SC 29464-4188
(843) 425-6526
Mailing address
1031 CHUCK DAWLEY BLVD STE 3, MT PLEASANT, SC 29464-4188
(843) 425-6526
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4165
SC
Other
Enumeration date
10/05/2024
Last updated
10/05/2024
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