JALON ALEXANDER MCCULLOUGH

FAIRBANKS, AK
NPI1104438365
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2020-08-19
Last Update Date2020-08-19
Business Address
JALON ALEXANDER MCCULLOUGH
542 4TH AVE STE B-101
FAIRBANKS, AK 99701-4707
Phone number: 907-374-1097
Mailing Address
JALON ALEXANDER MCCULLOUGH
PO BOX 73004
FAIRBANKS, AK 99707-3004
Phone number: 907-374-1097
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