Individual
TUCKER WILLI COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4249 HIGHWAY 411, STE 4, MADISONVILLE, TN 37354-1544
(423) 436-0309
(423) 436-0310
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6126
TN
Other
Enumeration date
01/06/2016
Last updated
01/06/2016
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