Doctor Name: | THOMAS MOLLETT |
NPI Number: | 1679713440 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 40553 |
Business Practice Address: | 132 Forest Dr Ona, WV - 255459743 |
Business Phone Number: | 3047336980 |
Business Fax Number: | |
Mailing Address: | 132 Forest Dr, ONA |
State: | WV |
Postal Code: | 255459743 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/05/2009 |
NPI Last Update Date: | 03/05/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WE0003X |
License Number: | 40553 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Emergency |
Taxonomy Definition: |