Provider Demographics
NPI:1770390957
Name:MOLNAR, CHARITY ROSE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:CHARITY
Middle Name:ROSE
Last Name:MOLNAR
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:CHARITY
Other - Middle Name:ROSE
Other - Last Name:MOLNAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MASSAGE THERAPIST
Mailing Address - Street 1:2165 E GRIZZLY BEAR DR
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-2721
Mailing Address - Country:US
Mailing Address - Phone:907-982-4565
Mailing Address - Fax:
Practice Address - Street 1:1001 E BOGARD RD
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7114
Practice Address - Country:US
Practice Address - Phone:907-376-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK169791225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist