Provider Demographics
NPI:1922291210
Name:JAMES, M. CULLERS, D.C.
Entity Type:Organization
Organization Name:JAMES, M. CULLERS, D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:CULLERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-672-2385
Mailing Address - Street 1:555 W GRANADA BLVD STE B9
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-9491
Mailing Address - Country:US
Mailing Address - Phone:386-672-2385
Mailing Address - Fax:386-672-2755
Practice Address - Street 1:555 W GRANADA BLVD STE B9
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-9491
Practice Address - Country:US
Practice Address - Phone:386-672-2385
Practice Address - Fax:386-672-2755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH002778111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88229Medicare PIN