Individual
GABRIELLE RENEE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
114 W 7TH ST, OKMULGEE, OK 74447-5052
(918) 756-3330
Mailing address
21712 W DUNCAN RD, HASKELL, OK 74436-5019
(918) 927-2477
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3365
OK
Other
Enumeration date
06/01/2021
Last updated
06/01/2021
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