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1730616574
MICHAEL JOHN DOHERTY
MUNSTER, IN
NPI
1730616574
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36002268A)
Enumeration Date
2017-05-11
Last Update Date
2017-05-11
Business Address
-- MICHAEL JOHN DOHERTY ATC, LAT, DPT
10133 DEVONSHIRE LN
MUNSTER, IN 46321-4376
Phone number: 219-381-1861
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Mailing Address
-- MICHAEL JOHN DOHERTY ATC, LAT, DPT
10133 DEVONSHIRE LN
MUNSTER, IN 46321-4376
Phone number:
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