Individual
MR. LEONARD TUCKER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6500 KIRBY GATE BLVD, MEMPHIS, TN 38119-2673
(901) 752-0772
Mailing address
2384 HEATHER RDG, SOUTHAVEN, MS 38672-9274
(901) 848-2534
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06738
TN
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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