MEDICARE: MOLLY ERIN ALFERMANN 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	225100000X	Physical Therapist	2013028462	MO

General Provider Information

NPI Number	:	1831521616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY ERIN ALFERMANN DPT

Provider Business Mailing Address
First Line	:	7421 HIGHWAY N
Second Line	:	SUITE B
City	:	DARDENNE PRAIRIE
State	:	MO
Zip	:	63368-7014
Country	:	US
Telephone Number	:	636-561-2060
Fax Number	:

Provider Business Practice Location Address
First Line	:	7421 HIGHWAY N
Second Line	:	SUITE B
City	:	DARDENNE PRAIRIE
State	:	MO
Zip	:	63368-7014
Country	:	US
Telephone Number	:	636-561-2060
Fax Number	:

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

Provider Enumeration Date	:	08/05/2013
Last Update Date	:	08/05/2013

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