MEDICARE: MR. BRIAN M DOOLAN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1699756437	WI

General Provider Information

NPI Number	:	1699756437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRIAN M DOOLAN DPT

Provider Business Mailing Address
First Line	:	4722 FARWELL ST UNIT 2
Second Line	:
City	:	MCFARLAND
State	:	WI
Zip	:	53558-9412
Country	:	US
Telephone Number	:	608-838-7232
Fax Number	:	608-838-7405

Provider Business Practice Location Address
First Line	:	4722 FARWELL ST
Second Line	:
City	:	MCFARLAND
State	:	WI
Zip	:	53558-9412
Country	:	US
Telephone Number	:	608-838-7232
Fax Number	:	608-838-7405

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	07/03/2023

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