Provider Demographics
NPI:1578898961
Name:HUFF-MOLLICA, MARSHA M (OD)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:M
Last Name:HUFF-MOLLICA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69921 THE MDWS
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9349
Mailing Address - Country:US
Mailing Address - Phone:740-695-1655
Mailing Address - Fax:
Practice Address - Street 1:69921 THE MDWS
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9349
Practice Address - Country:US
Practice Address - Phone:740-695-1655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3946152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist