Organization
TRANSLATIONAL MEDICINE CLINIC & RESEARCH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICKY WAYNE MCCULLOUGH MD (PRESIDENT)
(860) 477-0961
Entity
Organization
Contact information
Practice address
1768 STORRS RD, SUITE A, STORRS, CT 06268-1260
(860) 477-0961
Mailing address
48 MOOSUP VALLEY RD, FOSTER, RI 02825-1236
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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