Provider Demographics
NPI:1730383050
Name:CULLEN, AMBER DOROTHEA (DPT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:DOROTHEA
Last Name:CULLEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BANBURY DR
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3502
Mailing Address - Country:US
Mailing Address - Phone:978-692-5627
Mailing Address - Fax:
Practice Address - Street 1:9 BANBURY DR
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3502
Practice Address - Country:US
Practice Address - Phone:978-692-5627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA179252251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic