Individual
BRADLEY D MULKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3525 E LOUISE DR, SUITE 400, MERIDIAN, ID 83642
(208) 322-1680
(208) 685-2282
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-5180
(208) 381-5190
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA511
ID
Other
Enumeration date
06/01/2006
Last updated
03/31/2022
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