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NPI Code Detail

MEDICARE: STACY T DOLAN PT

MEDICARE:   STACY T DOLAN  PT
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
1225100000XPhysical Therapist440MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1440OTHERMTPTP-PT-LIC

General Provider Information

NPI Number : 1932441862
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY T DOLAN PT
Provider Business Mailing Address
First Line : 1600 HOSPITAL WAY
Second Line :
City : WHITEFISH
State : MT
Zip : 59937-7849
Country : US
Telephone Number : 406-863-3500
Fax Number :
Provider Business Practice Location Address
First Line : 1343 US HIGHWAY 93 N
Second Line :
City : EUREKA
State : MT
Zip : 59917-9503
Country : US
Telephone Number : 406-297-2438
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2013
Last Update Date : 03/18/2013

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Directions to “ STACY T DOLAN PT” Practice Location

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