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Individual

HEIDI MARIE TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
202 POMFRET ST, PUTNAM, CT 06260
(860) 963-7917
Mailing address
40 MANSFIELD AVE, WILLIMANTIC, CT 06226-2018
(860) 963-7916

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
271687
MA
207Q00000X
Family Medicine Physician
Primary
63797
CT

Other

Enumeration date
05/22/2014
Last updated
07/09/2019
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