Provider Demographics
NPI:1376267252
Name:GLADDING, MOLLY (CPHT)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:GLADDING
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 S CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-1125
Mailing Address - Country:US
Mailing Address - Phone:616-232-0531
Mailing Address - Fax:
Practice Address - Street 1:1151 W RANDALL ST STE A
Practice Address - Street 2:
Practice Address - City:COOPERSVILLE
Practice Address - State:MI
Practice Address - Zip Code:49404-1355
Practice Address - Country:US
Practice Address - Phone:616-837-6219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5303004524183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician