Healthcare Provider Details

I. General information

NPI: 1003030867
Provider Name (Legal Business Name): BRIAN CULLINEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 SCHOOL ST
LOWELL MA
01851-1341
US

IV. Provider business mailing address

PO BOX 517
NEEDHAM HEIGHTS MA
02494-0011
US

V. Phone/Fax

Practice location:
  • Phone: 978-458-6620
  • Fax: 978-458-6671
Mailing address:
  • Phone: 781-559-8700
  • Fax: 781-559-8778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1833
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: