Individual
JAY MCCULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
250 S LAKE ST, EAST JORDAN, MI 49727-9376
(231) 536-0901
Mailing address
250 S LAKE ST, EAST JORDAN, MI 49727-9376
(231) 536-0901
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302021369
MI
Other
Enumeration date
04/22/2011
Last updated
04/22/2011
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