Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 7978 | TN |
N | 226300000X | Kinesiotherapist |
NPI | 1629029939 |
---|---|
Provider Name | Dr. David Roger Dolbow |
First Address | Hermitage, TN 37076-4710 |
Second Address | Hermitage, TN 37076-4710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 09/02/2009 |