Individual
ALEXIS PAMALA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
PO BOX 2185, MCCALL, ID 83638
(541) 409-3039
Mailing address
PO BOX 2185, MCCALL, ID 83638
(541) 409-3039
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-858
ID
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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