Individual
JULIE TUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24 SOUTHPARK SHOPPING CTR, NASHVILLE, AR 71852-3307
(870) 845-3813
(870) 845-3808
Mailing address
24 SOUTHPARK SHOPPING CTR, NASHVILLE, AR 71852-3307
(870) 845-3813
(870) 845-3808
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
CPED3851
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CPED3851
CERTIFIED PEDORTHIST
AR
Enumeration date
09/20/2012
Last updated
09/20/2012
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