Individual
ALLEN JACOB TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
MSC 06 3500, UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 925-4031
(505) 925-4030
Mailing address
MSC 06 3500, UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 925-4031
(505) 925-4030
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
TD-00-66
NM
Other
Enumeration date
04/15/2014
Last updated
07/07/2014
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