NPI 1083929400

Gary Tucker

Practitioner Occupational Therapy Assistant Kosciusko, MS

Practice location

Address: 310 Autumn Ridge Dr, Kosciusko, MS 39090-3242
Phone: (662) 289-3499
Mailing address: 4109 Highway 98 W, Summit, MS 39666-9132

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence TA0288 (MS)

Other Occupational Therapy Assistant providers in Mississippi →

Registry record

NPI: 1083929400
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Aug 2010
Record last updated: 10 Aug 2010

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.