Individual
LISA MULLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1707 QUAIL RUN, MUSKOGEE, OK 74403-8458
(918) 805-6318
Mailing address
1707 QUAIL RUN, MUSKOGEE, OK 74403-8458
(918) 805-6318
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
11/16/2016
Last updated
11/16/2016
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