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NPI Code Detail

MEDICARE: MOLLY LYNCH RD

MEDICARE:   MOLLY  LYNCH  RD
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
1133V00000XRegistered DietitianCO

General Provider Information

NPI Number : 1336016021
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY LYNCH RD
Provider Business Mailing Address
First Line : 3985 S JASON ST
Second Line :
City : ENGLEWOOD
State : CO
Zip : 80110-4534
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1905 N SHERMAN ST STE 200
Second Line :
City : DENVER
State : CO
Zip : 80203-1132
Country : US
Telephone Number : 812-461-7988
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2025
Last Update Date : 03/03/2026

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Directions to “ MOLLY LYNCH RD” Practice Location

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