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1780208959
BRIAN THOMAS MCCULLOUGH
PHOENIX, AZ
NPI
1780208959
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: AZ 241813)
Enumeration Date
2020-06-03
Last Update Date
2020-06-05
Business Address
Mr. BRIAN THOMAS MCCULLOUGH PMHNP
34406 N. 27TH DRIVE SUITE 140 OFFICE 103
PHOENIX, AZ 85085-6082
Phone number: 623-688-1508
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Mailing Address
Mr. BRIAN THOMAS MCCULLOUGH PMHNP
34406 N. 27TH DRIVE SUITE 140 OFFICE 103
PHOENIX, AZ 85085-6082
Phone number: 623-688-1508
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