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Individual

ROBERT SHAWN TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
2558 S BRENTWOOD BLVD, #1 BRENTWOOD PHYSICAL THERAPY, ST. LOUIS, MO 63144
(314) 961-8940
(314) 961-8969
Mailing address
2558 S BRENTWOOD BLVD, #1 BRENTWOOD PHYSICAL THERAPY, ST. LOUIS, MO 63144
(314) 961-8940
(314) 961-8969

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
113988
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
231348
BC/BS
01
7477014
AETNA
Enumeration date
09/29/2008
Last updated
09/29/2008
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