Provider Demographics
NPI:1306239629
Name:FIORE, MOLLY
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:FIORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:BOOKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:715 HORIZON DR
Mailing Address - Street 2:STE 225
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8700
Mailing Address - Country:US
Mailing Address - Phone:970-683-7107
Mailing Address - Fax:970-683-7167
Practice Address - Street 1:137 HOWARD ST
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631
Practice Address - Country:US
Practice Address - Phone:970-328-6969
Practice Address - Fax:970-328-6329
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker