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General NPI Number Information
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NPI Number | 1861868713
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Entity Type | Individual
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Provider Name | NOAH SCOTT TUCKER PT
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Gender | Male
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Dates
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Enumeration Date | 08/14/2015
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 2913 RIVER RD W STE G
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City | GOOCHLAND
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State | VA
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Zip | 23063-3263
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Country | US
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Telephone | 804-556-0539
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 392573
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City | PITTSBURGH
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State | PA
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Zip | 15251-9573
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT011967
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305211281
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License Number State | VA
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