Individual
MRS. TAQUANA BERNETTA HOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2000
Mailing address
21 BOY SCOUT CT, AUGUSTA, GA 30909-2076
(893) 312-4670
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1958
SC
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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