Individual
DIANA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4801 DORSEY HALL DR, SUITE 130, ELLICOTT CITY, MD 21042-7766
(410) 730-9851
(410) 730-9855
Mailing address
4801 DORSEY HALL DR, SUITE 130, ELLICOTT CITY, MD 21042-7766
(410) 730-9851
(410) 730-9855
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2081
MD
Other
Enumeration date
09/27/2005
Last updated
07/08/2007
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