Individual
MR. DEREK WILLIAM TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 PROFESSIONAL CT, JESUP, GA 31545-0044
(912) 427-0800
Mailing address
33 LAURENBURG DR, RICHMOND HILL, GA 31324-5197
(912) 507-8021
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
08/11/2019
Last updated
08/11/2019
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