Individual
MARY ANN DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1030 EDMONDS ST, JEFFERSON CITY, MO 65109-5213
(615) 896-6400
Mailing address
310 SMOKY MOUNTAIN CT, COLUMBIA, MO 65203-8001
(615) 896-6400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02034
MO
Other
Enumeration date
03/03/2009
Last updated
03/03/2009
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