Provider Demographics
NPI:1245023456
Name:NICHOLS, MOLLY (PT)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 148TH ST
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:IA
Mailing Address - Zip Code:50005-9606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2721 STANGE RD STE 108
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3978
Practice Address - Country:US
Practice Address - Phone:515-293-0172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist