Provider Demographics
NPI:1033571757
Name:OEHL, MOLLY (MED, ATC, LAT)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:
Last Name:OEHL
Suffix:
Gender:F
Credentials:MED, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 KATHRYN ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-1016
Mailing Address - Country:US
Mailing Address - Phone:337-967-3075
Mailing Address - Fax:
Practice Address - Street 1:762 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT MARTINVILLE
Practice Address - State:LA
Practice Address - Zip Code:70582-4125
Practice Address - Country:US
Practice Address - Phone:337-394-3135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAATH:2001112255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer