Individual
LAURA MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 355-1355
Mailing address
8535 BURCH PARK DR, EVANSVILLE, IN 47725-6554
(812) 598-4659
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06005137A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06005137A
PTA LICENSE
IN
Enumeration date
03/12/2018
Last updated
03/12/2018
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