RYAN T MCCULLOCH

CHUBBUCK, ID
NPI1720195530
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA405)
Enumeration Date2006-08-25
Last Update Date2010-12-20
Business Address
-- RYAN T MCCULLOCH PA
147 W CHUBBUCK RD
CHUBBUCK, ID 83202-2314
Phone number: 208-238-7546
Mailing Address
-- RYAN T MCCULLOCH PA
147 W CHUBBUCK RD
CHUBBUCK, ID 83202-2314
Phone number: 208-238-7546
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