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1730553512
PHILLIP TUCKER
OKLAHOMA CITY, OK
NPI
1730553512
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: OK 695)
Enumeration Date
2015-11-17
Last Update Date
2015-11-17
Business Address
-- PHILLIP TUCKER ATC, LAT
12613 S WESTERN AVE
OKLAHOMA CITY, OK 73170-6903
Phone number: 405-735-4800
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Mailing Address
-- PHILLIP TUCKER ATC, LAT
2609 SE 7TH ST
MOORE, OK 73160-6776
Phone number: 580-214-0782
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