Provider Demographics
NPI:1851762678
Name:CULBREATH, TODD
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:
Last Name:CULBREATH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3212 W CHELTENHAM AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-1003
Mailing Address - Country:US
Mailing Address - Phone:610-203-6900
Mailing Address - Fax:610-203-6900
Practice Address - Street 1:3212 W CHELTENHAM AVE STE 2
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19150-1003
Practice Address - Country:US
Practice Address - Phone:161-020-3690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03105237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist