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Individual

ALYSSA MULLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
7610 PERSHING BLVD, KENOSHA, WI 53142-4318
(262) 948-3600
Mailing address
10400 75TH ST, KENOSHA, WI 53142-8323

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15054
WI
225100000X
Physical Therapist
15054-24
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40252000
WI
Enumeration date
10/05/2020
Last updated
10/27/2022
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