Individual
VIRGINIA MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
170 MORTON ST, JAMAICA PLAIN, MA 02130-3735
(617) 971-3788
Mailing address
170 MORTON ST, JAMAICA PLAIN, MA 02130-3735
(617) 971-3788
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
512
MA
Other
Enumeration date
02/12/2007
Last updated
07/08/2007
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