Corey Tucker, PTA

NPI #1720553423 in Keller, Texas

Provider Information

NPI Number: 1720553423
Entity Type: Individual
Name: Corey Tucker, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Oct 9, 2018
Last Updated: Oct 9, 2018

Practice Location

Address: 601 S MAIN ST STE 105
City: Keller
State: Texas
ZIP Code: 76248-7027
Phone: (972) 393-8067

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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