Individual
DR. GAYLE TUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
CORNERS OF ROUTES N12&N7, FORT DEFIANCE, AZ 86504-0649
(928) 729-8325
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202211499
VA
Other
Enumeration date
11/01/2013
Last updated
11/01/2013
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