Individual
SANDY L MCCULLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
160 GROVER ST, BAGLEY, WI 53801-9533
(608) 412-2669
Mailing address
160 GROVER ST, BAGLEY, WI 53801-9533
(608) 412-2669
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
247890-30
WI
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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