Individual
DOUGLAS ALBERT MULLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1101 PLANTATION ISLAND DR S, ST AUGUSTINE, FL 32080-6191
(904) 540-6114
Mailing address
1692 LEON ST, ST AUGUSTINE, FL 32080-5510
(904) 540-6114
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8656
FL
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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