Individual
KIMBERLY TUCKER-BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1640 ASHLEY HALL RD, CHARLESTON, SC 29407-3824
(843) 277-2411
Mailing address
1133 RIVERCREST DR, CHARLESTON, SC 29412-9348
(843) 259-0495
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5010
SC
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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