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General NPI Number Information
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NPI Number | 1245919414
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Entity Type | Individual
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Provider Name | SANDRA J TUCKER
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Gender | Female
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Dates
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Enumeration Date | 07/14/2023
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | RAPID RECOVERY CENTER OF NEW ENGLAND 835 CENTRAL AVE.
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City | DOVER
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State | NH
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Zip | 03820
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Country | US
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Telephone | 603-743-4885
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Fax |
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Provider Business Mailing Address
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Address Line | 70 BRATTLE ST
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City | SOUTH BERWICK
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State | ME
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Zip | 03908-1701
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Country | US
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Telephone | 603-436-9390
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT1402
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License Number State | NH
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