Individual
TUCKER KEITH FORBES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1275 HIGHWAY 54 W STE 200, FAYETTEVILLE, GA 30214-4538
(770) 460-8609
(770) 460-8629
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-4915
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003037
GA
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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