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NPI Code Detail

MEDICARE: MOLLY BARGERSTOCK MPT

MEDICARE:   MOLLY  BARGERSTOCK  MPT
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
1225100000XPhysical TherapistPT-010620-LPA
2225100000XPhysical Therapist2305005462VA

General Provider Information

NPI Number : 1851491914
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY BARGERSTOCK MPT
Provider Business Mailing Address
First Line : 5388 DISCOVERY PARK BLVD STE 200
Second Line :
City : WILLIAMSBURG
State : VA
Zip : 23188-8218
Country : US
Telephone Number : 757-707-3955
Fax Number : 757-603-6231
Provider Business Practice Location Address
First Line : 516 JAMISON AVE
Second Line :
City : ELLWOOD CITY
State : PA
Zip : 16117-2590
Country : US
Telephone Number : 724-758-7044
Fax Number : 724-758-3126
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 10/21/2024

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Directions to “ MOLLY BARGERSTOCK MPT” Practice Location

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