Provider Demographics
NPI:1497089064
Name:DOLBEN, HOLLIS H (PT)
Entity Type:Individual
Prefix:
First Name:HOLLIS
Middle Name:H
Last Name:DOLBEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 MONTANA ST
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-4325
Mailing Address - Country:US
Mailing Address - Phone:781-834-9352
Mailing Address - Fax:
Practice Address - Street 1:31 MONTANA ST
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-4325
Practice Address - Country:US
Practice Address - Phone:781-834-9352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3842225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist