Provider Demographics
NPI:1063711646
Name:MEEHAN AND MULLINS PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:MEEHAN AND MULLINS PHYSICAL THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:SLAY
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:817-602-9298
Mailing Address - Street 1:12457 TIMBERLAND BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5210
Mailing Address - Country:US
Mailing Address - Phone:817-602-9298
Mailing Address - Fax:866-247-9762
Practice Address - Street 1:632 SINGING QUAIL TRL
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-4183
Practice Address - Country:US
Practice Address - Phone:817-602-9298
Practice Address - Fax:866-247-9762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX670320000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy