Individual
KLINT DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
9520 E 520 S, WOLCOTTVILLE, IN 46795-9745
(269) 437-7421
Mailing address
3428 BLOOMSBURY LN, INDIANAPOLIS, IN 46228
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/03/2015
Last updated
06/17/2019
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