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Individual

LARRY MULLIS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC, LAT

Contact information

Practice address
1203 COLUMBIA DR, MILLEDGEVILLE, GA 31061-2395
(478) 452-6200
(478) 452-6212
Mailing address
1203 COLUMBIA DR, MILLEDGEVILLE, GA 31061-2395
(478) 452-6200
(478) 452-6212

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000595
GA

Other

Enumeration date
01/08/2007
Last updated
07/08/2007
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