Tucker, Kenneth A
Tucker, Kenneth A is an sole proprietor health care provider with primary practice located at 711 D St #102, San Rafael CA 94901-3707. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Tucker, Kenneth A can be contacted via phone (415) 456-3551.Contact Information
Primary practice address
711 D St #102
San Rafael CA 94901-3707
Phone: (415) 456-3551
Fax: (415) 457-7260
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT006218 | California |
Profile Details
NPI number | 1225006430 |
---|---|
LBN Legal business name | Tucker, Kenneth A |
Credentials | Physical Therapist (PT) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Mar 14th, 2006 |
Last updated | Aug 10th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1225006430 | NPPES |
California | Other | 94-6366835 | TAX ID# |
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