Provider Demographics
NPI:1528438751
Name:CARBOY, MOLLY (DPT)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:CARBOY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14360 W 116TH ST APT 3402
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-3857
Mailing Address - Country:US
Mailing Address - Phone:845-313-2447
Mailing Address - Fax:
Practice Address - Street 1:6701 W 121ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2003
Practice Address - Country:US
Practice Address - Phone:303-242-2027
Practice Address - Fax:610-335-4007
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8711225100000X
COPTL.0013660225100000X
KS11-06941225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist