Individual
MARY MULLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 LINCOLN DR, CHARLESTON, WV 25309-2304
(304) 984-0046
Mailing address
1000 LINCOLN DR, CHARLESTON, WV 25309-2304
(304) 984-0046
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001825
WV
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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