Individual
KEITH M CULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ORTHOTIST
Contact information
Practice address
1111 E END BLVD, WILKES BARRE, PA 18711-0030
(570) 824-3521
Mailing address
2126 RANSOM RD, DALLAS, PA 18612-8205
(570) 824-3521
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
ABCC0004397
PA
Other
Enumeration date
07/13/2006
Last updated
07/09/2007
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