Provider Demographics
NPI:1023231016
Name:CULLUM, DAN (DC)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:
Last Name:CULLUM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 271
Mailing Address - Street 2:
Mailing Address - City:TURPIN
Mailing Address - State:OK
Mailing Address - Zip Code:73950-9583
Mailing Address - Country:US
Mailing Address - Phone:580-778-3310
Mailing Address - Fax:580-778-3340
Practice Address - Street 1:RR 2 BOX 271
Practice Address - Street 2:
Practice Address - City:TURPIN
Practice Address - State:OK
Practice Address - Zip Code:73950-9583
Practice Address - Country:US
Practice Address - Phone:580-778-3310
Practice Address - Fax:580-778-3340
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2652111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor