Tucker, Kenneth A

Tucker, Kenneth A is an sole proprietor health care provider with primary practice located at 711 D St #102, San Rafael CA 94901-3707. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Tucker, Kenneth A can be contacted via phone (415) 456-3551.

Contact Information

Primary practice address
711 D St #102 San Rafael CA 94901-3707
Phone: (415) 456-3551
Fax: (415) 457-7260
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT006218 California

Profile Details

NPI number 1225006430
LBN Legal business name Tucker, Kenneth A
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 14th, 2006
Last updated Aug 10th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225006430 NPPES
California Other 94-6366835 TAX ID#

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