Individual
MS. PATRICIA E MCCULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1651 GALISTEO ST, SUITE 8, SANTA FE, NM 87505-4752
(505) 820-9870
(505) 983-1265
Mailing address
1651 GALISTEO ST, SUITE 8, SANTA FE, NM 87505-4752
(505) 820-9870
(505) 983-1265
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-059
NM
363AM0700X
Medical Physician Assistant
PA2004-0017
NM
Other
Enumeration date
08/16/2005
Last updated
11/05/2010
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