Provider Demographics
NPI:1841730553
Name:PILCHER, MOLLY JAE (ATC)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:JAE
Last Name:PILCHER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3497 HILLCREST RD
Mailing Address - Street 2:APARTMENT 4
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-3839
Mailing Address - Country:US
Mailing Address - Phone:563-357-7449
Mailing Address - Fax:
Practice Address - Street 1:2005 KANE ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-0538
Practice Address - Country:US
Practice Address - Phone:563-583-9771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0012012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer