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Individual

ROSANNE TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
1305 NATIONAL RD, WHEELING, WV 26003-5705
(304) 242-1390
(304) 243-5880
Mailing address
1305 NATIONAL RD, WHEELING, WV 26003-5705
(304) 242-1390
(304) 243-5880

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4151732
WV MEDICARE PTAN
WV
05
7305199000
WV
Enumeration date
06/21/2005
Last updated
09/26/2012
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