MEDICARE: DAWNE ELIZABETH MOLL DPT

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
1	2251P0200X	Pediatric Physical Therapist	PTL.0006423	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457548109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWNE ELIZABETH MOLL DPT

Provider Business Mailing Address
First Line	:	834 S. PERRY ST. STE. F
Second Line	:	PMB #432
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-1941
Country	:	US
Telephone Number	:	719-229-5364
Fax Number	:

Provider Business Practice Location Address
First Line	:	834 S. PERRY STE. F
Second Line	:	PMB #432
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-1941
Country	:	US
Telephone Number	:	719-229-5364
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2007
Last Update Date	:	03/06/2026

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