Individual
COLIN MICHAEL MULLALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
3278 MITCHELL BLVD, MOODY AFB, GA 31699-1500
(229) 257-7569
Mailing address
3278 MITCHELL BLVD, MOODY AFB, GA 31699-1500
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
09/19/2018
Last updated
09/22/2023
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