Provider Demographics
NPI:1699756437
Name:DOOLAN, BRIAN M (DPT)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:M
Last Name:DOOLAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4722 FARWELL ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:MCFARLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53558-9412
Mailing Address - Country:US
Mailing Address - Phone:608-838-7232
Mailing Address - Fax:608-838-7405
Practice Address - Street 1:4722 FARWELL ST
Practice Address - Street 2:
Practice Address - City:MCFARLAND
Practice Address - State:WI
Practice Address - Zip Code:53558-9412
Practice Address - Country:US
Practice Address - Phone:608-838-7232
Practice Address - Fax:608-838-7405
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1699756437225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP00164840OtherRAILROAD MEDICARE INDIV #
WIP00164840OtherRAILROAD MEDICARE INDIV #
WI000083033Medicare PIN