| Blake Molis, DC | |
|
3378 W 3500 S, West Valley City, UT 84119-2630 | |
| (801) 966-0342 | |
| Not Available |
| Full Name | Blake Molis |
|---|---|
| Gender | Male |
| Speciality | Chiropractor |
| Location | 3378 W 3500 S, West Valley City, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104640903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 6250645-1202 (Utah) | Primary |
| Provider Name | Able Chiropractic Professional Corporation |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1881872786 PECOS PAC ID: 9032157318 Enrollment ID: O20050418001050 |
| Mailing Address | Practice Location Address |
|---|---|
| Blake Molis, DC 3378 W 3500 S, West Valley City, UT 84119-2630 Ph: (801) 966-0342 | Blake Molis, DC 3378 W 3500 S, West Valley City, UT 84119-2630 Ph: (801) 966-0342 |
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