Provider Demographics
NPI:1275618233
Name:DOLAK, JOSEPH JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JOHN
Last Name:DOLAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 BOYDEN RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-2542
Mailing Address - Country:US
Mailing Address - Phone:508-829-0300
Mailing Address - Fax:508-829-0464
Practice Address - Street 1:61 BOYDEN RD
Practice Address - Street 2:SUITE 203
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520-2542
Practice Address - Country:US
Practice Address - Phone:508-829-0300
Practice Address - Fax:508-829-0464
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2902111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY37041OtherBLUE CROSS BLUE SHIELD
MAY45731Medicare ID - Type Unspecified