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1629186135
MARK MULLETT
LAKE CHARLES, LA
NPI
1629186135
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: LA 210697)
Enumeration Date
2006-08-25
Last Update Date
2007-07-08
Business Address
Mr. MARK MULLETT OT
3221 RYAN ST SUITE D
LAKE CHARLES, LA 70601
Phone number: 337-439-3344
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Mailing Address
Mr. MARK MULLETT OT
4924 S PRIEN LAKE RD
LAKE CHARLES, LA 70605
Phone number:
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