Individual
DR. MICHAEL A TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1155 POCATELLO CREEK RD, POCATELLO, ID 83201-2949
(208) 233-2020
(208) 233-2021
Mailing address
1155 POCATELLO CREEK RD, POCATELLO, ID 83201-2949
(208) 233-2020
(208) 233-2021
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPD - 100304
ID
Other
Enumeration date
06/16/2014
Last updated
06/16/2014
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