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Individual

ANNETTE MARIE MULLIKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
121 RAILROAD AVE, MANCOS, CO 81328-9059
(970) 533-7649
Mailing address
121 RAILROAD AVE, MANCOS, CO 81328-9059
(970) 533-7649

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1930
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
66021081
CO
Enumeration date
08/16/2007
Last updated
08/24/2009
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