Provider Demographics
NPI:1629363866
Name:GITTINGS, MOLLY (DPT)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:GITTINGS
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 1:2 STABLE GATE CT
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9684
Mailing Address - Country:US
Mailing Address - Phone:717-203-0463
Mailing Address - Fax:
Practice Address - Street 1:1420 CLARKVIEW RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2104
Practice Address - Country:US
Practice Address - Phone:443-213-0395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0003205225100000X
MD23664225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist