Provider Demographics
NPI:1699795906
Name:RESSLER, MOLLIE KATHRYN (MPT)
Entity type:Individual
Prefix:MRS
First Name:MOLLIE
Middle Name:KATHRYN
Last Name:RESSLER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4318 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-3342
Mailing Address - Country:US
Mailing Address - Phone:970-204-0948
Mailing Address - Fax:970-377-1839
Practice Address - Street 1:1939 WILMINGTON DR
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-6299
Practice Address - Country:US
Practice Address - Phone:970-377-1422
Practice Address - Fax:970-377-1839
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7129225100000X, 2251S0007X, 2251X0800X
CO2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO658789OtherBC/BS ID
CO489088Medicare ID - Type UnspecifiedPROVIDER ID