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NPI 1477297018

NPI 1477297018 : CALLIE JO CULLEN DC : ORANGE, CT

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General NPI Number Information
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    NPI Number           |    1477297018
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    Entity Type          |    Individual 
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    Provider Name        |    CALLIE JO CULLEN DC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/20/2022
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    Last Update Date     |    04/20/2022
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Provider Practice Location Address
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    Address Line         |    391 BOSTON POST RD STE 1 
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    City                 |    ORANGE
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    State                |    CT
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    Zip                  |    06477-3578
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    Country              |    US
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    Telephone            |    203-799-3472
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3 SHARON AVE 
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    City                 |    WEST HAVEN
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    State                |    CT
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    Zip                  |    06516-6426
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    Country              |    US
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    Telephone            |    203-285-9196
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    2247
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    License Number State |    CT
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