Individual
JERMAINE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
36 INDIAN WELLS DR, MANVEL, TX 77578-3387
(757) 344-0980
Mailing address
36 INDIAN WELLS DR, MANVEL, TX 77578-3387
(757) 344-0980
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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