| Doctor Name: | TIMOTHY WAYNE TUCKER |
| NPI Number: | 1912969973 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MPT |
| License Number: | 21247 |
| Business Practice Address: | 790 Remington Blvd Bolingbrook, IL - 604404909 |
| Business Phone Number: | 6302962223 |
| Business Fax Number: | 6307599510 |
| Mailing Address: | 52 Rising Sun Town Ctr, RISING SUN |
| State: | MD |
| Postal Code: | 219111902 |
| Phone Number: | 4106580100 |
| Fax Number: | 4106580199 |
| NPI Enumeration Date: | 04/05/2006 |
| NPI Last Update Date: | 03/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 21247 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |