Individual
GERALD NELSON MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AMA, CAADC
Contact information
Practice address
770 RIVERSIDE AVE, STE 11, ADRIAN, MI 49221-1476
(517) 264-2244
(517) 263-3325
Mailing address
770 RIVERSIDE AVE, STE 11, ADRIAN, MI 49221-1476
(517) 264-2244
(517) 263-3325
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
MI
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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