Individual
NILE DELAWRENCE MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5320 E 81ST ST APT 724, TULSA, OK 74137-2221
(405) 812-8745
Mailing address
5320 E 81ST ST APT 724, TULSA, OK 74137-2221
(405) 812-8745
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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