Individual
COLIN MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
20 HOSPITAL DR, LOGAN, WV 25601-3452
(304) 831-1101
Mailing address
764 TIMBERLANE DR, GALION, OH 44833-1125
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
932
WV
Other
Enumeration date
02/26/2024
Last updated
11/14/2024
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