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Individual

AMY ELIZABETH MACMULLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1525 OAK PARK BLVD, LAKE CHARLES, LA 70601-8849
(337) 494-6767
(337) 494-6750
Mailing address
1525 OAK PARK BLVD, LAKE CHARLES, LA 70601-8849
(337) 494-6767
(337) 494-6750

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
07/07/2015
Last updated
07/10/2015
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