Individual
JESSE VERIS MULLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
410 BENEDICTA AVE, TRINIDAD, CO 81082-2005
(719) 846-8072
Mailing address
1505 HAYES ST, TRINIDAD, CO 81082-3728
(719) 846-3594
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
05/30/2007
Last updated
07/08/2007
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