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General NPI Number Information
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NPI Number | 1538980594
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Entity Type | Individual
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Provider Name | DONALD WALTER CULLEY PTA
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Gender | Male
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Dates
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Enumeration Date | 10/22/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 9337 KREWSTOWN RD
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City | PHILADELPHIA
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State | PA
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Zip | 19115-3710
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Country | US
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Telephone | 215-676-6760
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Fax |
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Provider Business Mailing Address
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Address Line | 21 VINE LN
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City | LEVITTOWN
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State | PA
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Zip | 19054-1305
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Country | US
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Telephone | 267-980-5216
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | TEI006231
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License Number State | PA
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