Provider Demographics
NPI:1154911535
Name:MCMULLEN, WILLIAM DEVON (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DEVON
Last Name:MCMULLEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DEVON
Other - Middle Name:
Other - Last Name:MCMULLEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:600 5TH ST SE STE 2
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-4915
Mailing Address - Country:US
Mailing Address - Phone:605-878-0167
Mailing Address - Fax:
Practice Address - Street 1:600 5TH ST SE STE 2
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-4915
Practice Address - Country:US
Practice Address - Phone:605-878-0167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1389111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor