Individual
MRS. MARY LOU MCCULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CDE
Contact information
Practice address
303 NW 11TH ST, FAIRFIELD, IL 62837-1203
(618) 842-2611
(618) 847-8388
Mailing address
303 NW 11TH ST, FAIRFIELD, IL 62837-1203
(618) 842-2611
(618) 847-8388
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
041359796
IL
Other
Enumeration date
08/13/2015
Last updated
08/13/2015
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