Individual
MR. COREY JAMAL TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1803 ERLEN RD, ELKINS PARK, PA 19027-1064
(215) 272-8746
Mailing address
1803 ERLEN RD, ELKINS PARK, PA 19027-1064
(215) 272-8746
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/05/2022
Last updated
01/05/2022
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