Individual
KARA MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1600 UNIVERSITY AVE, BOLIVAR, MO 65613-2578
(417) 777-7763
Mailing address
6929 N FARM ROAD 159, SPRINGFIELD, MO 65803-8215
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2018029781
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000031997
BOARD OF CERTIFICATION, INC.
—
Enumeration date
09/07/2020
Last updated
09/07/2020
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