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Individual
ALLISON ELIZABETH TUCKER
Active
Individual
ALLISON ELIZABETH TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2169PA
—
SC
Enumeration date
04/10/2015
Last updated
07/16/2015
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