Individual
JASON MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
928 LEWIS CT, HENDERSON, NV 89015-5753
(909) 730-9457
Mailing address
928 LEWIS CT, HENDERSON, NV 89015-5753
(909) 730-9457
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
NVMT.10294
NV
Other
Enumeration date
07/05/2022
Last updated
07/05/2022
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