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Individual

ANDRE' M TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC/L

Contact information

Practice address
76 LOU GROZA BLVD, BEREA, OH 44017-1238
(440) 891-5127
Mailing address
76 LOU GROZA BLVD, BEREA, OH 44017-1238
(440) 891-5127

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.003338
OH

Other

Enumeration date
03/04/2013
Last updated
03/04/2013
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