Individual
BRENT MULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
750 MORRIS RD SE, LOS LUNAS, NM 87031-5242
(505) 866-2300
Mailing address
2551 COORS BLVD NW, ALBUQUERQUE, NM 87120-1213
(505) 338-3320
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-06741
NM
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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