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Mr. Steven Glenn Mccullough, COLO
Prosthetic/Orthotic Supplier in Longview, Texas
NPI 1629379490

Steven Glenn Mccullough is a Prosthetic/Orthotic Supplier based in Longview, TX. Steven Glenn Mccullough practices in Longview, TX and has the professional credentials of COLO. The NPI Number for Steven Glenn Mccullough is 1629379490 and holds a License No. 101239 (Texas).

The current practice location address for Steven Glenn Mccullough is 422 N Green St, Longview, TX and can be reached out via phone at 903-234-9300 and via fax at 903-234-8704.

Location: 422 N Green St, Longview, TX, 75601-6458
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629379490
Provider Name
Steven Glenn Mccullough
Credential
COLO
Provider Entity Type
Individual
Gender
Male
Address
422 N Green St, Longview, TX, 75601-6458
Phone Number
903-234-9300
Fax Number
903-234-8704
Provider Enumeration Date
11/10/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
422 N Green St
City
Longview
State
Texas
Zip
75601-6458
Phone Number
903-234-9300
Fax Number
903-234-8704
person
Provider Business Mailing Address Details
Address
422 N Green St
City
Longview
State
Texas
Zip
75601-6458
Phone Number
903-234-9300
Fax Number
903-234-8704
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
101239 (Texas)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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