Individual
SALLY MULHOLLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-3104
Mailing address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-3104
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN073902
GA
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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