Individual
JOSEPH BRADLEY MULLIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
1015 NEW MOODY LN, LA GRANGE, KY 40031-9142
(502) 222-5292
(502) 222-5274
Mailing address
129 ALTON RD, SHELBYVILLE, KY 40065-1447
(859) 230-1300
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
111891
KY
156FX1800X
Optician
CLD8386
CA
156FX1800X
Optician
SLD41354
CA
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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