Healthcare Provider Details

I. General information

NPI: 1255815569
Provider Name (Legal Business Name): MOLLY JONES, CMT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 09/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2516 E BELTLINE
HIBBING MN
55746-2302
US

IV. Provider business mailing address

539 E 39TH ST
HIBBING MN
55746-3131
US

V. Phone/Fax

Practice location:
  • Phone: 218-421-5396
  • Fax:
Mailing address:
  • Phone: 218-421-5396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MOLLY E JONES
Title or Position: OWNER/OPERATOR
Credential: CMT
Phone: 218-421-5396