Individual
GARY EDWARD MULLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R PH
Contact information
Practice address
724 S ATHERTON ST, SUITE 100, STATE COLLEGE, PA 16801-4628
(814) 238-2712
(814) 238-0480
Mailing address
224 CANTERBURY DR, STATE COLLEGE, PA 16803-1206
(814) 237-9094
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP027461L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP027461L
PHARMACY LICENSE
PA
Enumeration date
02/05/2007
Last updated
07/08/2007
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