Individual
MR. TERRY LEE MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
01546 COUNTY ROAD 665, BLOOMINGDALE, MI 49026-8756
(269) 512-6163
Mailing address
01546 COUNTY ROAD 665, BLOOMINGDALE, MI 49026-8756
(269) 512-6163
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
9689166
MI
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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