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1235636598
MARK ANTHONY DOCKERTY
MARION, IN
NPI
1235636598
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN MATS127)
Enumeration Date
2018-04-12
Last Update Date
2018-04-12
Business Address
Mr. MARK ANTHONY DOCKERTY MATS
317 S NORTON ST
MARION, IN 46952-3296
Phone number: 765-664-0101
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Mailing Address
Mr. MARK ANTHONY DOCKERTY MATS
317 S NORTON ST
MARION, IN 46952-3296
Phone number: 765-664-0101
Copy
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