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General NPI Number Information
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NPI Number | 1538177969
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Entity Type | Individual
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Provider Name | PATRICK WILLIAM DOLAN P.T.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 2522 W SAINT VRAIN ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80904-2517
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Country | US
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Telephone | 719-629-6796
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Fax | 888-505-3617
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Provider Business Mailing Address
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Address Line | 2522 W SAINT VRAIN ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80904-2517
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Country | US
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Telephone | 410-730-9851
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Fax | 410-730-9855
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5483
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License Number State | CO
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