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Individual

MS. JODY L MOLDENHAUER

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
1033 BASIN AVE, HEALTHWAYS, BISMARCK, ND 58504-6649
(701) 223-6613
(701) 221-9114
Mailing address
325 N 31ST ST, APT 2, BISMARCK, ND 58501-5188
(701) 391-5584

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1368
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1368
PT LICENSE NUMBER
ND
01
2271970
AMERICA'S PPO ID
ND
Enumeration date
02/14/2006
Last updated
07/09/2007
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