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General NPI Number Information
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NPI Number | 1265738777
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Entity Type | Individual
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Provider Name | MOLLY CATHARINE SOMMER PTA
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Gender | Female
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Dates
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Enumeration Date | 01/31/2011
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Last Update Date | 01/31/2011
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Provider Practice Location Address
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Address Line | 64 DANBURY RD
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City | WILTON
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State | CT
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Zip | 06897-4429
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Country | US
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Telephone | 203-834-3073
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Fax |
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Provider Business Mailing Address
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Address Line | 55 ROUNDWOOD CT
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City | AMHERST
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State | NY
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Zip | 14228-2823
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Country | US
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Telephone | 716-691-5605
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2306603001
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA22338
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License Number State | FL
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