Individual
DERRICK MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1221 E 16TH ST, HOLLAND, MI 49423-9127
(616) 396-7095
Mailing address
10655 RILEY ST, ZEELAND, MI 49464-6856
(313) 333-6355
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502003389
MI
Other
Enumeration date
11/06/2013
Last updated
11/06/2013
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