Provider Demographics
NPI:1033250832
Name:FILA, MOLLY
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:FILA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 890
Mailing Address - Street 2:319 HWY 14 SOUTH 1
Mailing Address - City:YELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72687-0890
Mailing Address - Country:US
Mailing Address - Phone:870-449-5177
Mailing Address - Fax:870-449-5178
Practice Address - Street 1:319 HWY 14 SOUTH 1
Practice Address - Street 2:
Practice Address - City:YELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72687
Practice Address - Country:US
Practice Address - Phone:870-449-5177
Practice Address - Fax:870-449-5178
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator