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Individual

NICHOLAS MICHAEL MCCULLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
125 N 13TH ST, CENTERVILLE, IA 52544-1705
(641) 437-4099
(641) 437-0512
Mailing address
125 N 13TH ST, CENTERVILLE, IA 52544-1705
(641) 437-4099
(641) 437-0512

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002489
IA

Other

Enumeration date
06/30/2010
Last updated
10/22/2013
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