Healthcare Provider Details

I. General information

NPI: 1841409828
Provider Name (Legal Business Name): KRISTY LEE MOLNAR LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36855 RIDGE RD
WILLOUGHBY OH
44094-4128
US

IV. Provider business mailing address

835 N LAKE ST
MADISON OH
44057-2944
US

V. Phone/Fax

Practice location:
  • Phone: 440-942-4342
  • Fax: 440-942-4150
Mailing address:
  • Phone: 440-428-0026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number4956
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: