Individual
MS. LINDA KETTNER TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
5000 MEQUON ROAD, MEQUON, WI 53092
(262) 238-5821
Mailing address
13345 N WINDSOR CT, MEQUON, WI 53097-2018
(262) 643-4421
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
1294-024
WI
2251P0200X
Pediatric Physical Therapist
Primary
12944-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20182700
—
WI
Enumeration date
04/20/2009
Last updated
04/20/2009
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