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1487030490
CLINTON MCCULLOUGH
SAINT PAUL, MN
NPI
1487030490
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MN 2331)
Enumeration Date
2015-08-03
Last Update Date
2015-08-03
Business Address
Mr. CLINTON MCCULLOUGH ATC
435 PHALEN BLVD
SAINT PAUL, MN 55130-5302
Phone number: 651-254-8368
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Mailing Address
Mr. CLINTON MCCULLOUGH ATC
435 PHALEN BLVD
SAINT PAUL, MN 55130-5302
Phone number: 651-254-8368
Copy
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