Individual
MS. LAURA MICHELLE TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, LMP
Contact information
Practice address
629 LYCHEE PL, MERRITT ISLAND, FL 32952-4023
(321) 720-1088
Mailing address
PO BOX 360613, MELBOURNE, FL 32936-0613
(321) 720-1088
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
00022531
FL
Other
Enumeration date
07/14/2008
Last updated
07/14/2008
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