NPI 1003547415

Michael Joseph Mullan, PTA

Practitioner Physical Therapy Assistant Olympia Fields, IL

Practice location

Address: 20201 Crawford Ave, Olympia Fields, IL 60461-1010
Phone: (708) 852-2540

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 160.009578 (IL)

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Registry record

NPI: 1003547415
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Jun 2022
Record last updated: 17 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.