MEDICARE: DR. ERIN K TUCKER PT, DPT

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	225100000X	Physical Therapist	P19823	NC
2	225100000X	Physical Therapist	10331	SC
3	225100000X	Physical Therapist	2000145880	MO
4	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1689896334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIN K TUCKER PT, DPT

Provider Business Mailing Address
First Line	:	313 MINERS COVE WAY
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-6509
Country	:	US
Telephone Number	:	417-380-3248
Fax Number	:

Provider Business Practice Location Address
First Line	:	313 MINERS COVE WAY
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-6509
Country	:	US
Telephone Number	:	417-380-3248
Fax Number	:

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	06/22/2024

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