Individual
JACOB MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
17 IVORY DR, YUKON, OK 73099-5035
(972) 259-0606
Mailing address
17 IVORY DR, YUKON, OK 73099-5035
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5657
OK
2251N0400X
Neurology Physical Therapist
Primary
5657
OK
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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