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1447800552
KEITH MCCULLOUGH
COEUR D ALENE, ID
NPI
1447800552
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2019-09-19
Last Update Date
2024-04-23
Business Address
KEITH MCCULLOUGH
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814-6051
Phone number: 208-625-4000
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Mailing Address
KEITH MCCULLOUGH
2587 E SPYGLASS CT
COEUR D ALENE, ID 83815-7948
Phone number:
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