Individual
NICHOLAS SCOTT DOLEZAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
3003 HWAY 95 STE 61, BULLHEAD CITY, AZ 86442-7896
(928) 440-6880
Mailing address
3003 HWAY 95 STE 61, BULLHEAD CITY, AZ 86442-7896
(928) 440-6880
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-32019
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPT-32019
ARIZONA STATE LICENSE
AZ
Enumeration date
09/27/2021
Last updated
09/27/2021
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