Provider Demographics
NPI:1699814376
Name:DOLAN, MICHAEL (ATC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:DOLAN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 MILL ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5152
Mailing Address - Country:US
Mailing Address - Phone:716-888-2964
Mailing Address - Fax:716-888-3219
Practice Address - Street 1:2001 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14208-1035
Practice Address - Country:US
Practice Address - Phone:716-888-2964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer