MICHAEL JOHN DOHERTY

MUNSTER, IN
NPI1730616574
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN  36002268A)
Enumeration Date2017-05-11
Last Update Date2017-05-11
Business Address
-- MICHAEL JOHN DOHERTY ATC, LAT, DPT
10133 DEVONSHIRE LN
MUNSTER, IN 46321-4376
Phone number: 219-381-1861
Mailing Address
-- MICHAEL JOHN DOHERTY ATC, LAT, DPT
10133 DEVONSHIRE LN
MUNSTER, IN 46321-4376
Phone number: