Individual
KATHLEEN L TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9493 S 700 E, SANDY, UT 84070-3459
(801) 576-0176
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 292-6100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
831698521205
UT
Other
Enumeration date
08/02/2006
Last updated
07/06/2010
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