Individual
SUE MCCULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 PARKWEST CIR STE 108, MIDLOTHIAN, VA 23114-5552
(540) 520-9411
Mailing address
43 TERRY PL, MOUNTAIN HOME, AR 72653-6713
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602289
VA
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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