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Individual

KENNETH DOLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
1419 SALT SPRINGS RD, SPORTS MEDICINE DEPARTMENT, SYRACUSE, NY 13214-1302
(315) 445-4417
Mailing address
116 GRAY AVE, 2B, SYRACUSE, NY 13203-1414
(315) 222-3644

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
04/20/2015
Last updated
04/20/2015
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