Provider Demographics
NPI:1730298662
Name:MULCAHY, ALAN LEE (PT)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:LEE
Last Name:MULCAHY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11947 SOUTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-7619
Mailing Address - Country:US
Mailing Address - Phone:561-204-2213
Mailing Address - Fax:561-204-2218
Practice Address - Street 1:11947 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-7619
Practice Address - Country:US
Practice Address - Phone:561-204-2213
Practice Address - Fax:561-204-2218
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT3285225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT3285OtherPT LICENSE