Provider Demographics
NPI:1083275432
Name:HAMILTON, MOLLY RAE (DC)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:RAE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:DC
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 188
Mailing Address - Street 2:
Mailing Address - City:JEWELL
Mailing Address - State:IA
Mailing Address - Zip Code:50130
Mailing Address - Country:US
Mailing Address - Phone:515-310-0329
Mailing Address - Fax:
Practice Address - Street 1:608 MAIN ST.
Practice Address - Street 2:
Practice Address - City:JEWELL
Practice Address - State:IA
Practice Address - Zip Code:50130
Practice Address - Country:US
Practice Address - Phone:515-310-0329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA097245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor