Individual
DR. BREONNA S TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT,DPT
Contact information
Practice address
3018 FESTIVAL WAY # 323, WALDORF, MD 20601-2958
(240) 754-5520
(301) 705-6797
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
29797
MD
Other
Enumeration date
01/11/2024
Last updated
02/05/2024
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