Individual
CHARLES ALLEN-WAYNE MULKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
STUDENT
Contact information
Practice address
302 N 3RD ST APT 513, SAINT JOSEPH, MO 64501-1856
(816) 898-4633
Mailing address
302 N 3RD ST APT 513, SAINT JOSEPH, MO 64501-1856
(816) 898-4633
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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