Individual
DAVID WILLIAM DOLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.-MASSAGE THERA
Contact information
Practice address
575 RIVERGATE, SUITE 95, DURANGO, CO 81301-7487
(505) 947-0112
Mailing address
PO BOX 2462, PAGOSA SPRINGS, CO 81147-2462
(505) 947-0112
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
7499
CO
225700000X
Massage Therapist
Primary
MA# 10055
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
593341785
FEIN
FL
01
—
7499
LICENSED MASSAGE THERAPIST
CO
01
—
MA# 10055
LIC. MASSAGE THERAPIST
FL
Enumeration date
03/17/2007
Last updated
03/18/2010
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