Individual
TONEIA TIERRA DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 PATEWOOD DR STE B350, GREENVILLE, SC 29615-6337
(864) 454-4500
(864) 454-4505
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6697
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5388
SC
363A00000X
Physician Assistant
—
SC
Other
Enumeration date
05/13/2024
Last updated
03/24/2025
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