Provider Demographics
NPI:1003264946
Name:STROTHER, MOLLY (PT)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:STROTHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4199 GATEWAY BLVD SUITE 3500
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8940
Mailing Address - Country:US
Mailing Address - Phone:812-858-5950
Mailing Address - Fax:
Practice Address - Street 1:4199 GATEWAY BLVD SUITE 3500
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8940
Practice Address - Country:US
Practice Address - Phone:812-858-5950
Practice Address - Fax:812-858-5955
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT31452225100000X
IN05013329A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y907MOtherBC/BS ID
Y927QOtherBC/BS ID
DO0550OtherRAILROAD MEDICARE
FLAM305OtherMEDICARE PTAN
IN300025473Medicaid