Provider Demographics
NPI:1790725968
Name:MULLIN, WILLIAM STEWART JR (MS, PT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:STEWART
Last Name:MULLIN
Suffix:JR
Gender:M
Credentials:MS, PT
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Mailing Address - Street 1:11417 ORCHARD PARK DR
Mailing Address - Street 2:APT. 121
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5547
Mailing Address - Country:US
Mailing Address - Phone:804-387-9985
Mailing Address - Fax:
Practice Address - Street 1:MCGUIRE VETERANS AFFAIRS MEDICAL CENTER
Practice Address - Street 2:1201 BROAD ROCK BOULEVARD
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-0001
Practice Address - Country:US
Practice Address - Phone:804-675-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA2305005443225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist