Individual
MRS. MARIE W MCCOLLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
301 ANDREWS AVENUE, FORT RUCKER, AL 36362
(334) 255-7894
Mailing address
304 YVONNE DRIVE, ENTERPRISE, AL 36330
(334) 347-1297
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-048685
AL
Other
Enumeration date
02/06/2008
Last updated
02/06/2008
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