Individual
CASEY SHANNON MULLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
128 E MAIN ST, NANTICOKE, PA 18634-1604
(570) 258-1304
Mailing address
26 MARTIN ST, HANOVER TOWNSHIP, PA 18706-1010
(570) 899-4522
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA066065
PA
Other
Enumeration date
09/27/2024
Last updated
09/29/2024
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