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Individual

LINDSAY ANNE TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
650 MEMORIAL DR, POCATELLO, ID 83209-0001
(208) 233-4339
Mailing address
2627 N 3RD ST, PHOENIX, AZ 85004-1113
(208) 202-0402

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AUD-2000
ID
231H00000X
Audiologist
DA12263
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1366570244
AZ
Enumeration date
09/15/2010
Last updated
08/05/2020
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