Provider Demographics
NPI:1851609754
Name:MOLINARO, MARY ANN (DPT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ANN
Last Name:MOLINARO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ANN
Other - Last Name:MCGUIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:715 W MAIN ST STE F
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-3553
Mailing Address - Country:US
Mailing Address - Phone:918-298-2381
Mailing Address - Fax:918-298-2357
Practice Address - Street 1:715 W MAIN ST STE F
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-3553
Practice Address - Country:US
Practice Address - Phone:918-298-2381
Practice Address - Fax:918-298-2357
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4318225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist