Individual
COLLIN MICHEAL TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 344, SIDNEY, IA 51652-0344
(785) 416-0763
Mailing address
PO BOX 344, SIDNEY, IA 51652-0344
(785) 416-0763
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
755AX9406
IA
Other
Enumeration date
06/20/2024
Last updated
06/20/2024
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