Individual
ANDRETTA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17541 GRANDVILLE AVE, DETROIT, MI 48219-3518
(313) 478-2032
Mailing address
17541 GRANDVILLE AVE, DETROIT, MI 48219-3518
(313) 478-2032
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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