Provider Demographics
NPI:1043874720
Name:MOLTHEN, BROOKE HILL (DPT)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:HILL
Last Name:MOLTHEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 PINEDALE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-4535
Mailing Address - Country:US
Mailing Address - Phone:336-414-7724
Mailing Address - Fax:
Practice Address - Street 1:12800 SPRUCE TREE WAY
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-7077
Practice Address - Country:US
Practice Address - Phone:844-568-4564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-28
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist