Provider Demographics
NPI:1699404343
Name:MULLINS, CHESTER MARVIN
Entity Type:Individual
Prefix:MR
First Name:CHESTER
Middle Name:MARVIN
Last Name:MULLINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5732 BROOK RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-2276
Mailing Address - Country:US
Mailing Address - Phone:804-615-5648
Mailing Address - Fax:804-421-8797
Practice Address - Street 1:5732 BROOK RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-2276
Practice Address - Country:US
Practice Address - Phone:804-615-5648
Practice Address - Fax:804-421-8797
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist