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General NPI Number Information
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NPI Number | 1639019763
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Entity Type | Individual
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Provider Name | MOLLY CROESSMANN PT
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Gender | Female
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Dates
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Enumeration Date | 03/30/2026
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Last Update Date | 03/30/2026
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Provider Practice Location Address
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Address Line | 111 W SOUTH 1ST ST UNIT A
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City | JOHNSTOWN
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State | CO
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Zip | 80534-9232
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Country | US
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Telephone | 970-510-8216
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Fax |
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Provider Business Mailing Address
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Address Line | 35 MAHON RD
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City | EDGEWOOD
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State | NM
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Zip | 87015-9439
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Country | US
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Telephone | 505-503-5536
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0021192
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License Number State | CO
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