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Individual

KE'ARA DENAE TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LAT, ATC

Contact information

Practice address
400 S MESA DR, HOPEWELL, VA 23860-4138
(434) 210-0755
Mailing address
1024 FINNEYWOOD RD, CHASE CITY, VA 23924-2606
(434) 210-0755

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126003552
VA

Other

Enumeration date
08/16/2019
Last updated
06/05/2022
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