Individual
MRS. CLEA PRISCILA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1821 WILSHIRE BLVD, SUITE 311, SANTA MONICA, CA 90403-5618
(310) 453-6166
(310) 453-6154
Mailing address
1821 WILSHIRE BLVD, SUITE 311, SANTA MONICA, CA 90403-5618
(310) 453-6166
(310) 453-6154
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
39033
CA
Other
Enumeration date
10/22/2012
Last updated
02/17/2014
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