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General NPI Number Information
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NPI Number | 1972482297
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Entity Type | Individual
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Provider Name | MOLLY DUDLEY PTA
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Gender | Female
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 8160 W COAL MINE AVE
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City | LITTLETON
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State | CO
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Zip | 80123-4431
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Country | US
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Telephone | 720-657-8670
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 S BROADWAY APT 107
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City | DENVER
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State | CO
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Zip | 80209-4009
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Country | US
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Telephone | 918-852-3503
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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 | 0015486
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License Number State | CO
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