Individual
KATHRYN L MCMULLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
323 E RIVERSIDE DR, STE 234, EAGLE, ID 83616-6864
(208) 938-4080
(208) 938-8922
Mailing address
323 E RIVERSIDE DR, STE 234, EAGLE, ID 83616-6864
(208) 938-4080
(208) 938-8922
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
M8497
ID
Other
Enumeration date
06/06/2006
Last updated
01/20/2010
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