Provider Demographics
NPI:1932637881
Name:DOLAN, RYAN PATRICK (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:PATRICK
Last Name:DOLAN
Suffix:
Gender:M
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 1:2272 RICHARDS AVE
Mailing Address - Street 2:
Mailing Address - City:ATCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08004-1260
Mailing Address - Country:US
Mailing Address - Phone:609-707-2261
Mailing Address - Fax:
Practice Address - Street 1:321 DORCHESTER AVE STE B
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2425
Practice Address - Country:US
Practice Address - Phone:410-228-5100
Practice Address - Fax:410-228-7479
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0016005225100000X
PAPT026390225100000X
CA298005225100000X
MA23540225100000X
MD29017225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist