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Individual

MR. JAMES FRANCIS MCCULLOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RDO

Contact information

Practice address
343 MAIN STREET, SOUTHBRIDGE SPECTACLE SHOP, SOUTHBRIDGE, MA 01550
(508) 765-9607
Mailing address
343 MAIN STREET, SOUTHBRIDGE, MA 01550
(508) 765-9607
(508) 765-9607

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
MA1543
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1522191
MA
Enumeration date
12/18/2006
Last updated
07/08/2007
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