Individual
AALIYAH TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
118 JUNIPER ST, MC DAVID, FL 32568-5400
(251) 253-0396
Mailing address
118 JUNIPER ST, MC DAVID, FL 32568-5400
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/21/2023
Last updated
06/21/2023
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