Individual
MRS. LAUREN MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-7899
Mailing address
163 FITZGERALD DR, TRAVIS AFB, CA 94535-1206
(951) 212-4140
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-1203
NV
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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