Individual
RYAN MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
123 SUMMER ST, WORCESTER, MA 01608-1216
(866) 691-6774
Mailing address
PO BOX 414977, BOSTON, MA 02241-4977
(866) 691-6774
(781) 276-6403
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/06/2012
Last updated
04/06/2012
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