KEITH MICHAEL MCCULLOUGH

COEUR D ALENE, ID
NPI1447800552
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-1818)
Enumeration Date2019-09-19
Last Update Date2025-08-03
Business Address
Mr. KEITH MICHAEL MCCULLOUGH PA-C
700 W IRONWOOD DR STE 175
COEUR D ALENE, ID 83814-4401
Phone number: 208-625-6300
Mailing Address
Mr. KEITH MICHAEL MCCULLOUGH PA-C
700 W IRONWOOD DR STE 175
COEUR D ALENE, ID 83814-4401
Phone number: 208-625-6309
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