Individual
MRS. MARTHA MAE TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2907 S 93RD EAST AVE, TULSA, OK 74129-6827
(918) 633-5260
(918) 517-3662
Mailing address
2322 S 87TH EAST AVE, TULSA, OK 74129-3030
(918) 633-5260
(918) 517-3662
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
OK
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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