Provider Demographics
NPI:1477787703
Name:TUCK, DEBORAH M (CMT, NCTMB)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:M
Last Name:TUCK
Suffix:
Gender:F
Credentials:CMT, NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20045 STEVENS CREEK BLVD
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-2353
Mailing Address - Country:US
Mailing Address - Phone:408-446-3128
Mailing Address - Fax:
Practice Address - Street 1:20045 STEVENS CREEK BLVD
Practice Address - Street 2:SUITE 2B
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2353
Practice Address - Country:US
Practice Address - Phone:408-446-3128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist