Provider Demographics
NPI:1982274551
Name:DR. MEGAN MULLIN PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:DR. MEGAN MULLIN PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PT
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:MULLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:518-888-5973
Mailing Address - Street 1:PO BOX 3180
Mailing Address - Street 2:
Mailing Address - City:SHELL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93448-3180
Mailing Address - Country:US
Mailing Address - Phone:518-888-5973
Mailing Address - Fax:
Practice Address - Street 1:188 TANK FARM RD
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7528
Practice Address - Country:US
Practice Address - Phone:518-888-5973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty