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Individual

BOBBY JOE TUCKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6315 PEARL RD STE 206, PARMA HEIGHTS, OH 44130-3074
(440) 613-5222
(440) 613-5222
Mailing address
712 PALMER AVE, YOUNGSTOWN, OH 44502-2531

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
OP.017156-S
OH
332H00000X
Eyewear Supplier

Other

Enumeration date
12/10/2020
Last updated
12/10/2020
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