Provider Demographics
NPI:1972482297
Name:DUDLEY, MOLLY (PTA)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:DUDLEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S BROADWAY APT 107
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-4009
Mailing Address - Country:US
Mailing Address - Phone:918-852-3503
Mailing Address - Fax:
Practice Address - Street 1:8160 W COAL MINE AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-4431
Practice Address - Country:US
Practice Address - Phone:720-657-8670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015486225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant