Individual
JASON DOUGHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
186 BREEZE LANE, CALVERT CITY, KY 42029
(270) 898-2773
Mailing address
186 BREEZE LN, CALVERT CITY, KY 42029
(270) 933-8621
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A02674
KY
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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