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1801480579
KENNETH TUCKER
FAIRMONT, WV
NPI
1801480579
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2021-02-23
Last Update Date
2021-02-23
Business Address
KENNETH TUCKER
186 APPLE VALLEY RD APT 5
FAIRMONT, WV 26554-7854
Phone number: 304-435-5283
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Mailing Address
KENNETH TUCKER
186 APPLE VALLEY RD APT 5
FAIRMONT, WV 26554-7854
Phone number:
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