Provider Demographics
NPI:1942671003
Name:CULLEN CHIROPRACTIC & WELLNESS PLLC
Entity Type:Organization
Organization Name:CULLEN CHIROPRACTIC & WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:CULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-927-2161
Mailing Address - Street 1:2206 JO AN DR, STE 1
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231
Mailing Address - Country:US
Mailing Address - Phone:941-927-2161
Mailing Address - Fax:941-927-2130
Practice Address - Street 1:2206 JO AN DR, STE 1
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231
Practice Address - Country:US
Practice Address - Phone:941-927-2161
Practice Address - Fax:941-927-2130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2014111N00000X
111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty