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General NPI Number Information
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NPI Number | 1154338788
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Entity Type | Organization
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Legal Business Name | CULLMAN PROFESSIONAL RESOURCES, INC
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 131 GOLFVIEW DR NE
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City | ARAB
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State | AL
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Zip | 35016-5473
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Country | US
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Telephone | 256-931-2307
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Fax |
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Provider Business Mailing Address
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Address Line | 131 GOLFVIEW DR NE
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City | ARAB
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State | AL
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Zip | 35016-5473
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Country | US
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Telephone | 256-931-2307
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICHOLAS T MANSUETTA
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Credential | D.O.
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Telephone | 256-931-2307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DO575
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License Number State | AL
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