Healthcare Provider Details

I. General information

NPI: 1952736837
Provider Name (Legal Business Name): MOLLY KANE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2013
Last Update Date: 09/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 COMMONWEALTH AVE
WARWICK RI
02886-2752
US

IV. Provider business mailing address

39 BARROWS DR
EAST GREENWICH RI
02818-2611
US

V. Phone/Fax

Practice location:
  • Phone: 401-823-1731
  • Fax:
Mailing address:
  • Phone: 401-575-9866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT02605
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: