Male or Other

Mr. Clinton Mccullough ATC

Athletic Trainer in Saint Paul, MN(View on Map)

Full Name

Mr. Clinton Mccullough ATC

NPI Number

1487030490

NPI Type

Individual Provider

Gender

Male

Enumeration Date

08/03/2015

Specialties

(Taxonomies)

Code

2255A2300X

Primary Taxonomy

Yes

Licenses

State

Minnesota

License Number

2331

Contact
Information

Purpose

Mailing
Location

Address

435 PHALEN BLVD
435 PHALEN BLVD

City

Saint Paul
Saint Paul

State

MN
MN

Postal Code

55130-5302
55130-5302

Country

US
US

Telephone Number

(651) 254-8368
(651) 254-8368

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/03/2015

Provider Address

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