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Jerry Tucker
NPI 1720522527 · on the registry since 2016 · sole proprietor
Practice
- Address
- 18336 Avon Ave
Detroit, MI 48219 - Phone
- (313) 704-3586
Registry record
- Primary taxonomy
- 225700000X
225700000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-12-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan