NPI 1033763347

Latrese Tucker

Practitioner Contractor Detroit, MI

Practice location

Address: 9600 Wyoming, Detroit, MI 48204
Phone: (313) 989-3411
Mailing address: 3835 Holcomb St, Detroit, MI 48214-1386

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X

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Registry record

NPI: 1033763347
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Jul 2019
Record last updated: 25 Jul 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.