Individual
DAWN MCCULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 COURTLAND DR, JACKSONVILLE, NC 28546-6017
(910) 265-1756
(910) 938-0045
Mailing address
113 COURTLAND DR, JACKSONVILLE, NC 28546-6017
(910) 265-1756
(910) 938-0045
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408969
—
NC
Enumeration date
12/04/2007
Last updated
12/04/2007
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