Individual
TERESA TANNER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
601 MATHIS FERRY RD, MT PLEASANT, SC 29464-2623
(843) 884-0212
(843) 884-0565
Mailing address
1164 TIDAL VIEW LN, CHARLESTON, SC 29412-8429
(843) 762-0618
(843) 884-0565
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
681
SC
Other
Enumeration date
05/16/2006
Last updated
07/08/2007
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