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NPI Code Detail

MEDICARE: MOLLY ANNE WINDMILLER P.T.A.

MEDICARE: MOLLY ANNE WINDMILLER P.T.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant06000563AIN

General Provider Information

NPI Number : 1154539609
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY ANNE WINDMILLER P.T.A.
Provider Business Mailing Address
First Line : 3043 LUCERNE AVE.
Second Line :
City : EVANSVILLE
State : IN
Zip : 47725
Country : US
Telephone Number : 812-626-0536
Fax Number :
Provider Business Practice Location Address
First Line : 2819 N SAINT JOSEPH AVE
Second Line :
City : EVANSVILLE
State : IN
Zip : 47720-1335
Country : US
Telephone Number : 812-424-2941
Fax Number : 812-423-6230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 03/22/2013

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