Healthcare Provider Details

I. General information

NPI: 1528247087
Provider Name (Legal Business Name): MS. ANNE MARIE DOLAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2007
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 OLD BEDFORD RD
BEDFORD NH
03110-5906
US

IV. Provider business mailing address

100 INDEPENDENCE WAY STE D3
DANVERS MA
01923-3875
US

V. Phone/Fax

Practice location:
  • Phone: 603-484-4070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5592
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number10758
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number10758
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: