Individual
MR. STEVEN GLENN MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.O.L.O.
Contact information
Practice address
422 N GREEN ST, LONGVIEW, TX 75601-6458
(903) 234-9300
(903) 234-8704
Mailing address
422 N GREEN ST, LONGVIEW, TX 75601-6458
(903) 234-9300
(903) 234-8704
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
101239
TX
Other
Enumeration date
11/10/2010
Last updated
12/05/2013
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