Provider Demographics
NPI:1134537087
Name:MOLONY, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:MOLONY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:KY
Mailing Address - Zip Code:41016-1408
Mailing Address - Country:US
Mailing Address - Phone:859-814-1459
Mailing Address - Fax:
Practice Address - Street 1:9255 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:KY
Practice Address - Zip Code:41091-7199
Practice Address - Country:US
Practice Address - Phone:859-305-5173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH014872225100000X
KY006458225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist