KEITH CHARLES MCCULLOCH

SYLMAR, CA
NPI1609050871
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-12-24
Last Update Date2007-12-24
Business Address
Mr. KEITH CHARLES MCCULLOCH
13741 FOOTHILL BLVD
SYLMAR, CA 91342-3133
Phone number: 818-833-9789
Mailing Address
Mr. KEITH CHARLES MCCULLOCH
1140 0BERLIN
GLENDALE, CA 91205
Phone number: 818-484-1591
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