Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT029158 | PA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT029158 | PA |
NPI | 1083205876 |
---|---|
Provider Name | Aaron Patrick Mccullough |
First Address | Pittsburgh, PA 15202-3428 |
Second Address | Pittsburgh, PA 15202-3428 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2021 |
Last Update Date | 03/03/2021 |