Individual
SHANELIA MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
288 OLD MILL RD APT 43, MAULDIN, SC 29662-2086
(864) 525-4655
Mailing address
288 OLD MILL RD APT 43, MAULDIN, SC 29662-2086
(864) 525-6930
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
179258E
SC
Other
Enumeration date
01/22/2016
Last updated
01/22/2016
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