Provider Demographics
NPI:1093191835
Name:CULLEN, ERIC PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:PAUL
Last Name:CULLEN
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 1:2206 JO AN DR STE 1
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-4080
Mailing Address - Country:US
Mailing Address - Phone:941-927-2161
Mailing Address - Fax:941-927-2130
Practice Address - Street 1:2206 JO AN DR STE 1
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-4080
Practice Address - Country:US
Practice Address - Phone:941-927-2161
Practice Address - Fax:941-927-2130
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13079111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor