Individual
MELANY MULLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(618) 549-0721
Mailing address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041423575
IL
Other
Enumeration date
11/13/2016
Last updated
12/04/2021
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