Provider Demographics
NPI:1952003600
Name:MOLLNOW, LUKE (DO)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:MOLLNOW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2597 OAK VISTA CT
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-7563
Mailing Address - Country:US
Mailing Address - Phone:303-656-3664
Mailing Address - Fax:
Practice Address - Street 1:10099 RIDGEGATE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5532
Practice Address - Country:US
Practice Address - Phone:720-225-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program