Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1833 | MA |
NPI | 1003030867 |
---|---|
Provider Name | Brian Culliney |
First Address | Needham Heights, MA 02494-0011 |
Second Address | Lowell, MA 01851-1341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 11/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
350324 | HARVARD PILGRIM HEALTHCAR (01) | MA |
407328 | TUFTS (01) | MA |
Y36311 | BCBS (01) | MA |