Individual
MARY TERESA DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
308 W BASELINE RD, LAFAYETTE, CO 80026-1719
(303) 503-1019
Mailing address
730 JULIAN CIR, LAFAYETTE, CO 80026-1164
(303) 503-1019
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1591
CO
Other
Enumeration date
10/05/2010
Last updated
10/05/2010
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