Individual
MR. BRIAN KEITH TUCKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, OCS, JSCCI
Contact information
Practice address
75 THOMAS JOHNSON DRIVE, SUITE L, FREDERICK, MD 21702-5125
(301) 698-9956
(301) 698-9957
Mailing address
75 THOMAS JOHNSON DRIVE, SUITE L, FREDERICK, MD 21702-5125
(301) 698-9956
(301) 698-9957
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16917
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1180364
UNITED HEALTHCARE
MD
01
—
473137
MAMSI
MD
01
—
52780008
CAREFIRST OF MARYLAND
MD
Enumeration date
06/02/2005
Last updated
03/25/2013
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