Healthcare Provider Details

I. General information

NPI: 1801728175
Provider Name (Legal Business Name): JAKE DOLSON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 OLD KINGS HWY S STE 120
DARIEN CT
06820-4532
US

IV. Provider business mailing address

19 OLD KINGS HWY S STE 120
DARIEN CT
06820-4532
US

V. Phone/Fax

Practice location:
  • Phone: 203-621-0050
  • Fax: 203-202-2727
Mailing address:
  • Phone: 203-621-0050
  • Fax: 203-202-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15400
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: