Provider Demographics
NPI:1457548109
Name:MOLL, DAWNE ELIZABETH (DPT)
Entity type:Individual
Prefix:
First Name:DAWNE
Middle Name:ELIZABETH
Last Name:MOLL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:D.
Other - Middle Name:
Other - Last Name:MOLL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS,PT
Mailing Address - Street 1:34431 SOUTHERN CROSS TRL
Mailing Address - Street 2:
Mailing Address - City:KIOWA
Mailing Address - State:CO
Mailing Address - Zip Code:80117-8962
Mailing Address - Country:US
Mailing Address - Phone:719-229-5364
Mailing Address - Fax:719-634-3956
Practice Address - Street 1:2 OAKWOOD PARK PLZ STE 200
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1885
Practice Address - Country:US
Practice Address - Phone:720-788-7365
Practice Address - Fax:720-294-0284
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.00064232251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO32572522Medicaid