Individual
MR. JASON KYLE DAUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
13385 FM 3039, CRANDALL, TX 75114-4818
(972) 427-6150
(972) 427-6133
Mailing address
13385 FM 3039, CRANDALL, TX 75114-4818
(972) 427-6150
(972) 427-6133
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT2638
TX
Other
Enumeration date
11/02/2011
Last updated
11/02/2011
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