Individual
MR. BARET DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
660 JOLLY RD NW, CALHOUN, GA 30701-8633
(239) 822-7947
Mailing address
17 MOUNTAIN CREEK DR SE, ROME, GA 30161-2146
(239) 822-7947
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003494
GA
Other
Enumeration date
01/18/2019
Last updated
01/18/2019
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