# JOSEPH BRADLEY MULLIGAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1558091173
- **Gender:** Man
- **Credential:** LDO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156FX1800X | Optician | 111891 | KY | Yes |
| 156FX1800X | Optician | CLD8386 | CA | — |
| 156FX1800X | Optician | SLD41354 | CA | — |

## Other

- **Enumeration date:** 06/15/2022
- **Last updated:** 06/15/2022