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1417332321
MICHAEL TUCKER
MILWAUKEE, WI
NPI
1417332321
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WI 3630-23)
Enumeration Date
2015-07-22
Last Update Date
2021-12-02
Business Address
MICHAEL TUCKER Physician Assistant
5171 N SANTA MONICA BLVD APT 4
MILWAUKEE, WI 53217-5538
Phone number: 414-828-7761
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Mailing Address
MICHAEL TUCKER Physician Assistant
5171 N SANTA MONICA BLVD APT 4
MILWAUKEE, WI 53217-5538
Phone number: 414-828-7761
Copy
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