Individual
SHANNON M MULLIGAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
604 LAKEWOOD RD, WATERBURY, CT 06704-2419
(203) 575-0900
(203) 573-9894
Mailing address
87 GRANDVIEW AVE, WATERBURY, CT 06708-2514
(203) 574-2020
(203) 596-2230
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002345
CT
Other
Enumeration date
05/12/2006
Last updated
07/08/2007
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