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Individual

MR. EDWARD M. DOHERTY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
A.T.,C

Contact information

Practice address
350 PROSPECT ST, BELMONT, MA 02478-2656
(617) 484-4410
Mailing address
42 PATCH HILL LN, MILFORD, NH 03055-4155
(603) 672-1302

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1549
MA

Other

Enumeration date
08/31/2005
Last updated
07/08/2007
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