Healthcare Provider Details

I. General information

NPI: 1124930235
Provider Name (Legal Business Name): MOLLY GILSETH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 147TH ST W STE 101
APPLE VALLEY MN
55124-4515
US

IV. Provider business mailing address

7460 128TH ST W APT 306
APPLE VALLEY MN
55124-7510
US

V. Phone/Fax

Practice location:
  • Phone: 612-508-2454
  • Fax:
Mailing address:
  • Phone: 612-437-5446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number870946
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: