Individual
MADISON GAYLE MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 NETHERLAND LN, KINGSPORT, TN 37660-7245
(423) 245-0360
Mailing address
141 BROOKS LANDING CIR, ROGERSVILLE, TN 37857-8040
(423) 754-7698
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
04/06/2020
Last updated
04/06/2020
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