Provider Demographics
NPI:1942817309
Name:HEMINGWAY, MOLLY K
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:K
Last Name:HEMINGWAY
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 1:2272 DEEP WOODS DR
Mailing Address - Street 2:
Mailing Address - City:EATON RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:48827-8211
Mailing Address - Country:US
Mailing Address - Phone:989-621-7846
Mailing Address - Fax:
Practice Address - Street 1:2272 DEEP WOODS DR
Practice Address - Street 2:
Practice Address - City:EATON RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:48827-8211
Practice Address - Country:US
Practice Address - Phone:989-621-7846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant