Individual
MR. GARRY LANE TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
813 S MAIN ST, BROWNSVILLE, KY 42210-9009
(270) 597-2335
Mailing address
280 MOORMAN LN, BOWLING GREEN, KY 42101-0711
(270) 792-1261
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
003618
KY
Other
Enumeration date
11/20/2012
Last updated
11/20/2012
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