Provider Demographics
NPI:1760609291
Name:SOLE, DORA GOSSELIN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DORA
Middle Name:GOSSELIN
Last Name:SOLE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2714 LYNNDALE CT
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-9165
Mailing Address - Country:US
Mailing Address - Phone:919-338-7836
Mailing Address - Fax:
Practice Address - Street 1:9009 HUNTER FOX CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-8270
Practice Address - Country:US
Practice Address - Phone:919-329-6637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101822251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics