Individual
WENDY A. MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
912 DUPONT RD, LOUISVILLE, KY 40207-4602
(502) 594-8757
Mailing address
2304 EVERGREEN RD, LOUISVILLE, KY 40223-1316
(502) 594-8757
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
KY003339
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00883
MEDICARE PTAN
KY
05
—
7100391860
—
KY
Enumeration date
02/01/2007
Last updated
04/07/2016
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