Individual
COLIN ALEXANDER MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.C., C.S.C.S.
Contact information
Practice address
140 COMMONWEALTH AVE, YAWKEY CENTER- ROOM 108, CHESTNUT HILL, MA 02467-3800
(617) 552-9113
(617) 552-9101
Mailing address
41 STRATHMORE RD APT 6, BRIGHTON, MA 02135-7935
(413) 329-6826
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2096
MA
Other
Enumeration date
05/06/2011
Last updated
05/06/2011
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