Individual
MR. DAVID LEE TUCKNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
902 N MAIN ST, SAN ANGELO, TX 76903-4077
(325) 655-7391
Mailing address
902 N MAIN ST, SAN ANGELO, TX 76903-4077
(325) 655-7391
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208900
TX
Other
Enumeration date
08/24/2018
Last updated
08/24/2018
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