Individual
IVAN MULLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, SCS, ATC
Contact information
Practice address
515 STATE ST, JOHNSTOWN, PA 15905-2646
(814) 254-0086
Mailing address
515 STATE STREET, JOHNSTOWN, PA 15904-2646
(814) 254-0086
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PA008858-L
PA
Other
Enumeration date
10/03/2006
Last updated
08/16/2007
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