Individual
CARMEN DANIELLE MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
895 STATE FARM RD STE 303, BOONE, NC 28607-4917
(828) 264-0501
Mailing address
4601 PARK RD STE 300, CHARLOTTE, NC 28209-2290
(704) 323-2090
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P19695
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0397730059
NSC #
NC
Enumeration date
04/07/2021
Last updated
04/07/2021
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