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NPI Code Detail

MEDICARE: MARY E MCCULLOUGH PT

MEDICARE: MARY E MCCULLOUGH PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT016445PA

General Provider Information

NPI Number : 1881636389
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY E MCCULLOUGH PT
Provider Business Mailing Address
First Line : 2631 W 8TH ST
Second Line :
City : ERIE
State : PA
Zip : 16505-4034
Country : US
Telephone Number : 814-464-0627
Fax Number : 814-464-0629
Provider Business Practice Location Address
First Line : 2631 W 8TH ST
Second Line :
City : ERIE
State : PA
Zip : 16505-4034
Country : US
Telephone Number : 814-464-0627
Fax Number : 814-464-0629
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2006
Last Update Date : 12/14/2023

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Directions to “ MARY E MCCULLOUGH PT” Practice Location

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