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MR. DERRICK TUCKER LMT
NPI 1629434576
Massage Therapist in Saint Louis, MO

Active since January 07, 2016
4102A SHENANDOAH AVE, SAINT LOUIS, MO 63110(314) 541-3924 Get Directions Write a Review

NPPES record last updated: January 7, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Derrick Tucker Lmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DERRICK TUCKER LMT (NPI 1629434576) is an individual massage therapist in Saint Louis, Missouri, licensed in Missouri (2013025861) and active in the NPI registry since January 2016.

NPPES Registry Identity

NPI1629434576
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameMR. DERRICK TUCKERCredential: LMT
Location Address4102A SHENANDOAH AVESaint Louis, MO 63110-3940
Mailing Address4102a Shenandoah AveSaint Louis, MO 63110-3940 · (314) 541-3924
Phone(314) 541-3924
Sole ProprietorNo
Enumeration DateJanuary 7, 2016
✔ NPI 1629434576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in MO · 2013025861
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
4102A SHENANDOAH AVE, Saint Louis, MO 63110
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Other Names 1

Professional Name (2)Detony Tucker Lmt

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derrick Tucker's NPI number?

The NPI number for Derrick Tucker is 1629434576. It was assigned to this individual provider in the NPPES registry on January 7, 2016. The provider is also known as Detony Tucker Lmt.

Where is Derrick Tucker located?

Derrick Tucker practices at 4102A Shenandoah Ave, Saint Louis, MO 63110. The listed phone number is (314) 541-3924.

What is Derrick Tucker's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Derrick Tucker was last updated on January 7, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.