Individual
MR. BONNIE LYNETTE MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
843 E KAY ST, MORTON, IL 61550-2242
(309) 265-5432
Mailing address
843 E KAY ST, MORTON, IL 61550-2242
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/09/2011
Last updated
05/09/2011
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