Provider Demographics
NPI:1881225068
Name:DOLAN, PAUL (DPT)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:DOLAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1769
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20118-1769
Mailing Address - Country:US
Mailing Address - Phone:703-388-0288
Mailing Address - Fax:703-388-0290
Practice Address - Street 1:8250 GREENSBORO DR
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-4902
Practice Address - Country:US
Practice Address - Phone:703-388-0288
Practice Address - Fax:703-388-0290
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305213266225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist