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NPI Code Detail

MEDICARE: DR. EDWARD FRANCIS MCCULLOUGH D.C.

MEDICARE: DR. EDWARD FRANCIS MCCULLOUGH D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor2296TN
2111N00000XChiropractor4367-12WI
3111N00000XChiropractor5731OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13672603OTHERTNPTAN

General Provider Information

NPI Number : 1558548677
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD FRANCIS MCCULLOUGH D.C.
Provider Business Mailing Address
First Line : 1633 SUMMIT LAKE SHORE RD NW
Second Line :
City : OLYMPIA
State : WA
Zip : 98502-9437
Country : US
Telephone Number : 360-810-5201
Fax Number :
Provider Business Practice Location Address
First Line : 2625 MARTIN WAY E STE A
Second Line :
City : OLYMPIA
State : WA
Zip : 98506-4900
Country : US
Telephone Number : 541-779-8338
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2008
Last Update Date : 07/13/2020

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