MEDICARE: TUCKER GOLDEN LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	1226	MS

General Provider Information

NPI Number	:	1184583932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TUCKER GOLDEN LMT

Provider Business Mailing Address
First Line	:	115 THORNHILL DR STE C
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-1559
Country	:	US
Telephone Number	:	601-397-7124
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 THORNHILL DR STE C
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-1559
Country	:	US
Telephone Number	:	601-397-7124
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ TUCKER GOLDEN LMT” Practice Location

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