Individual
SUZANNE K WING-DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5930 VANDERVOORT DR STE A, LINCOLN, NE 68516-2391
(402) 420-2099
(402) 420-2823
Mailing address
5930 VANDERVOORT DR STE A, LINCOLN, NE 68516-2391
(402) 420-2099
(402) 420-2823
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47077636832
—
NE
Enumeration date
06/30/2010
Last updated
06/30/2010
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