Provider Demographics
NPI:1306045885
Name:DOLAN, LISA FARRELL (LPT)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:FARRELL
Last Name:DOLAN
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:MAILE
Other - Last Name:FARRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPT
Mailing Address - Street 1:6209 VISTA TER
Mailing Address - Street 2:
Mailing Address - City:OREFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18069-9063
Mailing Address - Country:US
Mailing Address - Phone:610-530-0950
Mailing Address - Fax:414-908-7369
Practice Address - Street 1:6209 VISTA TER
Practice Address - Street 2:
Practice Address - City:OREFIELD
Practice Address - State:PA
Practice Address - Zip Code:18069-9063
Practice Address - Country:US
Practice Address - Phone:610-530-0950
Practice Address - Fax:414-908-7369
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006500L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist