Individual
SHA-JUANA MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20011 E 8 MILE RD, SAINT CLAIR SHORES, MI 48080-1692
(313) 442-3973
Mailing address
20011 E 8 MILE RD, SAINT CLAIR SHORES, MI 48080-1692
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703118069
MI
Other
Enumeration date
12/19/2017
Last updated
12/19/2017
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