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General NPI Number Information
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NPI Number | 1013482827
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Entity Type | Individual
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Provider Name | JENNIFER MARIE MULLIGAN DPT
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Gender | Female
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 4025 FAMILY PL
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7807
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Country | US
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Telephone | 719-471-4415
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Fax | 719-547-2487
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Provider Business Mailing Address
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Address Line | 9070 W CHEYENNE AVE STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89129-8935
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Country | US
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Telephone | 702-818-5000
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Fax | 702-818-5001
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL0051979
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License Number State | CO
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