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General NPI Number Information
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NPI Number | 1619104304
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Entity Type | Individual
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Provider Name | MOLLY ENDERS MS, LAC
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Gender | Female
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Dates
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Enumeration Date | 06/19/2009
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 24300 CHAGRIN BLVD STE 107
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City | BEACHWOOD
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State | OH
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Zip | 44122-5629
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Country | US
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Telephone | 216-973-7289
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Fax | 216-342-7077
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Provider Business Mailing Address
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Address Line | 2359 EDGERTON RD
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City | UNIVERSITY HTS
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State | OH
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Zip | 44118-3736
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Country | US
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Telephone | 216-973-7289
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 65.000140
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 66.000026
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License Number State | OH
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