Individual
MS. CASEY LEIGH MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
2043 SE 16TH AVE, PORTLAND, OR 97214-5327
(864) 546-0248
Mailing address
2043 SE 16TH AVE, PORTLAND, OR 97214-5327
(864) 546-0248
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC185395
OR
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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