Michael Mulligan, PTA

NPI #1104139229 in Beaverton, Oregon

Provider Information

NPI Number: 1104139229
Entity Type: Individual
Name: Michael Mulligan, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Jul 18, 2010
Last Updated: Jul 18, 2010

Practice Location

Address: 4855 SW WESTERN AVE
City: Beaverton
State: Oregon
ZIP Code: 97005-3460
Phone: (503) 526-7449

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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