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Individual

THOMAS MULLIGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, ATC, CSCS

Contact information

Practice address
401 CHANNELSIDE DR, TAMPA, FL 33602-5400
(813) 301-6793
Mailing address
10276 ESTUARY DR, TAMPA, FL 33647-3123

Taxonomy

Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
PT23678
FL
2255A2300X
Athletic Trainer
Primary
AL1418
FL

Other

Enumeration date
07/29/2017
Last updated
07/29/2017
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