Provider Demographics
NPI:1982068698
Name:MOLL, JOSHUA (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:MOLL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 EDSEL LN NW STE 1
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IN
Mailing Address - Zip Code:47112-2136
Mailing Address - Country:US
Mailing Address - Phone:812-734-0303
Mailing Address - Fax:812-225-5145
Practice Address - Street 1:2230 EDSEL LN NW STE 1
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IN
Practice Address - Zip Code:47112-2136
Practice Address - Country:US
Practice Address - Phone:812-734-0303
Practice Address - Fax:812-225-5145
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5497111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor