Individual
XAVIER M MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
898 HAMPTON RD, MCDONOUGH, GA 30253-6514
(678) 583-9954
(678) 583-8709
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
50253
CA
225200000X
Physical Therapy Assistant
Primary
CP005018A
GA
Other
Enumeration date
10/19/2019
Last updated
06/10/2021
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