Individual
MRS. ANNA LOIS MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
441 N WABASH AVE, MARION, IN 46952-2690
(765) 660-7139
Mailing address
706 N WINDSOR DR, MARION, IN 46952-2620
(765) 409-8621
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
693011
IN
Other
Enumeration date
02/10/2019
Last updated
02/10/2019
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