Individual
KELLY MARIE MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
269 MAIN ST, PORTLAND, CT 06480-1857
(860) 788-7976
Mailing address
269 MAIN ST, PORTLAND, CT 06480-1857
(860) 836-7902
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
012642
CT
Other
Enumeration date
08/08/2018
Last updated
11/04/2024
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