Kelly Mccullough

NPI #1063802981 in Brazil, Indiana

Provider Information

NPI Number: 1063802981
Entity Type: Individual
Name: Kelly Mccullough
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jan 30, 2015
Last Updated: Jan 30, 2015

Practice Location

Address: 954 N COUNTY ROAD 250 W
City: Brazil
State: Indiana
ZIP Code: 47834-7495
Phone: (812) 243-5925

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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