Provider Demographics
NPI:1538177969
Name:DOLAN, PATRICK WILLIAM (PT)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:WILLIAM
Last Name:DOLAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2522 W SAINT VRAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-2517
Mailing Address - Country:US
Mailing Address - Phone:410-730-9851
Mailing Address - Fax:410-730-9855
Practice Address - Street 1:2522 W SAINT VRAIN ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-2517
Practice Address - Country:US
Practice Address - Phone:719-629-6796
Practice Address - Fax:888-505-3617
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5483225100000X
MD171482251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports