Provider Demographics
NPI:1124328521
Name:DOLBY, ROBERT EDWARD
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:EDWARD
Last Name:DOLBY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-7936
Mailing Address - Country:US
Mailing Address - Phone:719-477-6870
Mailing Address - Fax:719-477-1483
Practice Address - Street 1:1775 S 8TH ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-7936
Practice Address - Country:US
Practice Address - Phone:719-477-6870
Practice Address - Fax:719-477-1483
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist