Individual
MR. MYRON JACOB CULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
310 NTH 9TH STREET, BISMARCK, ND 58506-5510
(701) 530-8100
(701) 530-8160
Mailing address
124 RIVERSIDE PARK RD, BISMARCK, ND 58504-5385
(701) 258-4415
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0784
ND
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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