Provider Demographics
NPI:1851792899
Name:MULLEN, ALEX (DVM)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:MULLEN
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36395 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4414
Mailing Address - Country:US
Mailing Address - Phone:440-918-1625
Mailing Address - Fax:440-918-1635
Practice Address - Street 1:36395 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4414
Practice Address - Country:US
Practice Address - Phone:440-918-1625
Practice Address - Fax:440-918-1635
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH9151174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian