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Individual
MR. SHAUN O DOLEN
Active
Individual
MR. SHAUN O DOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.P.
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
225000000X
Orthotic Fitter
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7795114
—
NC
Enumeration date
03/02/2007
Last updated
11/20/2007
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