Provider Demographics
NPI:1245222405
Name:MULLINS, JOSEPH EVANS (LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:EVANS
Last Name:MULLINS
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 HAMMOND ST
Mailing Address - Street 2:
Mailing Address - City:RANDLEMAN
Mailing Address - State:NC
Mailing Address - Zip Code:27317-1435
Mailing Address - Country:US
Mailing Address - Phone:336-420-1512
Mailing Address - Fax:
Practice Address - Street 1:600 W SALISBURY ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5590
Practice Address - Country:US
Practice Address - Phone:336-302-3249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC02082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer