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1629379490
STEVEN GLENN MCCULLOUGH
LONGVIEW, TX
NPI
1629379490
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
335E00000X Prosthetic/Orthotic Supplier
(Licence: TX 101239)
Enumeration Date
2010-11-10
Last Update Date
2013-12-05
Business Address
Mr. STEVEN GLENN MCCULLOUGH C.O.L.O.
422 N GREEN ST
LONGVIEW, TX 75601-6458
Phone number: 903-234-9300
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Mailing Address
Mr. STEVEN GLENN MCCULLOUGH C.O.L.O.
422 N GREEN ST
LONGVIEW, TX 75601-6458
Phone number: 903-234-9300
Copy
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