Healthcare Provider Details
I. General information
NPI: 1427549641
Provider Name (Legal Business Name): TUCKER'S HOUSE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2018
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 BEASLEY DR STE G
FRANKLIN TN
37064-3933
US
IV. Provider business mailing address
PO BOX 968
SPRING HILL TN
37174-0968
US
V. Phone/Fax
- Phone: 615-310-5224
- Fax:
- Phone: 615-310-5224
- Fax: 615-777-3173
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171WH0202X |
| Taxonomy | Home Modifications Contractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
SANDRA
CONSTANCE
ZACCARI
Title or Position: DIRECTOR OF NEEDS ASSESSMENT
Credential: PT
Phone: 615-491-2190