Tequila King, PTA
NPI #1689412082 in Ridgeland, South Carolina
Provider Information
- NPI Number
- 1689412082
- Entity Type
- Individual
- Name
- Tequila King, PTA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physical Therapy Assistant
- Credential
- PTA
- Enumeration Date
- Jul 18, 2024
- Last Updated
- Jul 18, 2024
Practice Location
- Address
- 567 N OKATIE HWY
- City
- Ridgeland
- State
- South Carolina
- ZIP Code
- 29936-5078
- Phone
- (843) 476-0736
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
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