Individual
DANIEL JAMES DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
45 MALLETT DR, COASTAL ORTHOPEDICS AND SPORTS MEDICINE, FREEPORT, ME 04032-1312
(207) 442-0325
(207) 443-4578
Mailing address
27 MACMILLAN DR, BRUNSWICK, ME 04011-3222
(207) 729-8581
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT2397
LICENSE #
ME
Enumeration date
08/25/2006
Last updated
03/01/2012
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