Individual
JESSE MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
121 BOONE RIDGE DR, SUITE 1006, JOHNSON CITY, TN 37615
(423) 282-0520
(423) 282-0520
Mailing address
PO BOX 325, DORTON, KY 41520-0325
(606) 794-8740
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000038748
TN
183500000X
Pharmacist
017462
KY
183500000X
Pharmacist
0202213552
VA
183500000X
Pharmacist
24684
NC
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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