Individual
SAMUEL MCMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
18 S CENTER ST, SOUTHINGTON, CT 06489-3121
(860) 621-5054
Mailing address
PO BOX 5000, ANNANDALE ON HUDSON, NY 12504-5000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12235
CT
2255A2300X
Athletic Trainer
002102-01
NY
Other
Enumeration date
10/22/2015
Last updated
05/31/2019
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