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Individual

REBECCA A. VAN DOLAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPAS

Contact information

Practice address
17 ALICE PECK DAY DR UNIT C, LEBANON, NH 03766-2684
(603) 448-6344
(603) 448-3405
Mailing address
10 ALICE PECK DAY DR, LEBANON, NH 03766-2900
(603) 448-3121
(603) 448-7462

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
189
NH
363A00000X
Physician Assistant
Primary
0947
NH
363A00000X
Physician Assistant
6026
CT

Other

Enumeration date
04/26/2006
Last updated
05/07/2023
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