Organization
NORTHWEST LIFE CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD MCCULLOUGH DC (CHIROPRACTIC PHYSICIAN)
(541) 500-8838
Entity
Organization
Contact information
Practice address
720 CARDLEY AVE, MEDFORD, OR 97504-6124
(541) 500-8838
Mailing address
720 CARDLEY AVE, MEDFORD, OR 97504-6124
(541) 500-8838
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5731
OR
Other
Enumeration date
04/06/2018
Last updated
04/06/2018
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