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Organization

RENEGADE PERFORMANCE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RYAN ANTHONY MULLEN D.C. (OWNER)
(607) 765-3281
Entity
Organization

Contact information

Practice address
3226 ELMIRA ST, SAYRE, PA 18840-2670
(607) 765-3281
Mailing address
413 SENECA ST, SAYRE, PA 18840-1742
(607) 765-3281

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC011215
PA

Other

Enumeration date
01/03/2017
Last updated
01/03/2017
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