Individual
PATRICIA M MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
167 MAIN STREET, TUBA CITY, AZ 86045
(866) 976-5941
Mailing address
PO BOX 1000, FLAGSTAFF, AZ 86002-1000
(928) 310-6368
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT-002508
AZ
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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