Individual
LACY AMES TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
103 CANOY LN, SUITE 113, CLEMSON, SC 29631-3153
(864) 654-2001
(800) 305-7112
Mailing address
103 CANOY LN, SUITE 113, CLEMSON, SC 29631-3153
(864) 654-2001
(800) 305-7112
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6081
SC
Other
Enumeration date
11/03/2010
Last updated
11/03/2010
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