Individual
KITIA MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1012 RIVERCLIFT DR, COVINGTON, GA 30016-8945
(718) 807-6845
Mailing address
863 FLAT SHOALS RD SE STE C161, CONYERS, GA 30094-6633
(718) 807-6845
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
GA
Other
Enumeration date
08/30/2017
Last updated
08/30/2017
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