Individual
STACY T DOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1343 US HIGHWAY 93 N, EUREKA, MT 59917-9503
(406) 297-2438
Mailing address
1600 HOSPITAL WAY, WHITEFISH, MT 59937-7849
(406) 863-3500
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
440
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
440
PTP-PT-LIC
MT
Enumeration date
03/18/2013
Last updated
03/18/2013
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