| NPI | 1083916910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HURD MCCULLOUGH Sole Member LLC 203-385-1166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 035958) |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2010-11-29 |