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NPI Code Detail

MEDICARE: MRS. MOLLY DUDICK PT

MEDICARE: MRS. MOLLY DUDICK PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251X0800XOrthopedic Physical Therapist2127NC
2225100000XPhysical Therapist2127NC

General Provider Information

NPI Number : 1326022716
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MOLLY DUDICK PT
Provider Business Mailing Address
First Line : 4601 PARK RD
Second Line : STE 300
City : CHARLOTTE
State : NC
Zip : 28209-3239
Country : US
Telephone Number : 704-323-2000
Fax Number :
Provider Business Practice Location Address
First Line : 710 PARK CENTER DR
Second Line : STE 300
City : MATTHEWS
State : NC
Zip : 28105-5012
Country : US
Telephone Number : 704-323-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 03/20/2013

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Directions to “ MRS. MOLLY DUDICK PT” Practice Location

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