Provider Demographics
NPI:1619737012
Name:HUFFMAN, MOLLY GRACE
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:GRACE
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4164 ROCKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-2629
Mailing Address - Country:US
Mailing Address - Phone:412-884-9209
Mailing Address - Fax:
Practice Address - Street 1:531 S COLLEGE AVE # 540
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19716-1304
Practice Address - Country:US
Practice Address - Phone:301-831-4295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0320532251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports