Provider Demographics
NPI:1851404446
Name:DOLAN, DAVID J (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:DOLAN
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 1:227 E LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-2614
Mailing Address - Country:US
Mailing Address - Phone:610-775-1700
Mailing Address - Fax:610-775-4496
Practice Address - Street 1:227 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-2614
Practice Address - Country:US
Practice Address - Phone:610-775-1700
Practice Address - Fax:610-775-4496
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003910L111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABC50000230OtherBLUE CROSS CHIROPRACTOR
PA111903Medicare PIN
PABC50000230OtherBLUE CROSS CHIROPRACTOR