Individual
MS. THERESA M MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3040 BERKMAR DR STE A1, CHARLOTTESVILLE, VA 22901-1593
(434) 979-8628
(434) 979-8536
Mailing address
1725 VERONA DR, CHARLOTTESVILLE, VA 22911-3545
(434) 466-3317
(434) 979-8536
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2305203454
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209238
SOUTHERN HEALTH
VA
01
—
7493361
AETNA
VA
Enumeration date
03/21/2007
Last updated
01/05/2026
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